NPIMap

Organization Active NPI

Cape Girardeau Behavioral Health LLC

Doing business as Southeast Behavioral Hospital

  • Psychiatric Hospital
  • Cape Girardeau, MO
National Provider Identifier
1700485281
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
CAPE GIRARDEAU BEHAVIORAL HEALTH LLC
Doing business as
Southeast Behavioral Hospital
Practice address
639 S Silver Springs Rd
Cape Girardeau, MO 63703-7539
Phone
(573) 708-5000
NPI assigned
Oct 26, 2020
Last updated
Jun 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Authorized official

Name
Steve Filton
Title
Vice President
Phone
(610) 768-3300

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Psychiatric Hospital 283Q00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

639 S Silver Springs Rd
Cape Girardeau, MO 63703-7539

Mailing address

639 S Silver Springs Rd
Cape Girardeau, MO 63703-7539

Other names 1

  • Southeast Behavioral Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210212000346 MO Part A Provider - Hospital 8022423649 Practice locations: Cape Girardeau, MO
O20210507002378 MO Part B Supplier - Clinic/Group Practice 8022423649 Receives reassigned benefits from 19 practitioners
Practice locations: Cape Girardeau, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700485281. Details of each certification follow.

Hospital certification: CCN 264034

Legal name
CAPE GIRARDEAU BEHAVIORAL HEALTH LLC
Doing business as
SOUTHEAST BEHAVIORAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jun 4, 2021
Last certification
Jun 4, 2021
Beds
102
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
639 S Silver Springs Rd
Cape Girardeau, MO 63703-7539
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Care Compare: Hospital

Medicare Care Compare
Listed as
Southeast Behavioral HospitalCCN 264034 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Cape Girardeau Behavior LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Shelah Adams Individual Corporate OfficerAssociate VP Mar 8, 2021 100%
Kenneth Bateman Individual Contracted Managing Employee Mar 8, 2021
Corporate Officer Mar 8, 2021
Mariellena Sudak Individual Corporate Officer Mar 8, 2021
Matthew D Klein Individual Corporate OfficerSecretary Aug 5, 2020 100%
Thomas M Day Individual Corporate OfficerVice President Jul 20, 2021 100%
Corporate DirectorVice President Jul 20, 2021 33.3%
Uhs Midwest Behavioral Health LLC Organization, King of Prussia, PA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 5, 2020 75%
Steve Filton Individual Corporate OfficerVice President Aug 5, 2020 100%
Corporate DirectorVice President Aug 5, 2020 33.3%
Operational/Managerial ControlVice President Aug 5, 2020 100%
Universal Health Services Inc Organization, King of Prussia, PA Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 5, 2020 100%
James M Coleman Individual Contracted Managing EmployeeSenior Reimbursement Manager Aug 5, 2020 50%
Matthew Theophil Janzow Individual Corporate Officer Mar 8, 2021
Southeast Hospital Organization, Cape Girardeau, MO Non-profit 5% Or Greater Direct Ownership Interest Aug 5, 2020 25%
Uhs of Delaware Inc Organization, King of Prussia, PA Corporation, Management services company, Chain home office, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 5, 2021 100%
Operational/Managerial Control Aug 5, 2020 100%
Alan B Miller Individual 5% Or Greater Indirect Ownership InterestChairman Mar 18, 2024 87.4%

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 183

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 183

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1700485281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 S SILVER SPRINGS RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637037539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 S SILVER SPRINGS RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637037539",
            "telephone_number": "573-708-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPE GIRARDEAU BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-26",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "FILTON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "610-768-3300"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Behavioral Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southeast Behavioral Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.