NPIMap

Organization Active NPI

Southeast Missouri Hospital Physicians, LLC

  • Rural Health Clinic/Center
  • Perryville, MO
National Provider Identifier
1700350543
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SOUTHEAST MISSOURI HOSPITAL PHYSICIANS, LLC
Practice address
624 Old Saint Marys Rd
Perryville, MO 63775-1837
Phone
(573) 547-3232
Fax
(573) 547-3231
NPI assigned
Jan 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Krista Berry
Title
Cfo
Phone
(573) 331-6028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

624 Old Saint Marys Rd
Perryville, MO 63775-1837

Mailing address

1701 Lacey St
Cape Girardeau, MO 63701-5230

Other names 1

  • Southeast Primary Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southeast Missouri Hos5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1700350543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 LACEY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637015230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 OLD SAINT MARYS RD",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751837",
            "telephone_number": "573-547-3232",
            "fax_number": "573-547-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MISSOURI HOSPITAL PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-15",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-331-6028"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Perryville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.