Southeast Health Center of Reynolds County, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SOUTHEAST HEALTH CENTER OF REYNOLDS COUNTY, LLC

Doing business as

SoutheastHEALTH Family Medicine of Van Buren

Practice address

1009 Business Hwy 60
Van Buren, MO 63965-9103

Phone

(573) 323-4812

Fax

(573) 323-4850

NPI assigned

Mar 4, 2014

Last updated

Mar 4, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paula E Harris

Title

Vice President Regional Operations

Phone

(573) 778-0020

Specialties & licenses 1

Addresses

Other names 1

• SoutheastHEALTH Family Medicine of Van Buren Doing business as

Member of 1

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

• Southeast Hospital

  dba Mercy Hospital Southeast

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1811006661

  Member Of

  NPD member

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1750706453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGHWAY 21 N",
            "city": "ELLINGTON",
            "state": "MO",
            "postal_code": "636389409",
            "telephone_number": "573-663-2511",
            "fax_number": "573-663-2815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 BUSINESS HWY 60",
            "city": "VAN BUREN",
            "state": "MO",
            "postal_code": "639659103",
            "telephone_number": "573-323-4812",
            "fax_number": "573-323-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST HEALTH CENTER OF REYNOLDS COUNTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT REGIONAL OPERATIONS",
        "authorized_official_telephone_number": "573-778-0020"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SoutheastHEALTH Family Medicine of Van Buren",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christina Ann Pryor, DMD
• Tina M. Reed, M.A., L.P.C.
• Jennifer Robertsonj, COTA/L
• Select Physical Therapy Holdings, Inc. (Select Physical Therapy)
• Skyline Assisted Living LLC
• Richard Joseph Stephens Jr.
• Katherine Alice Swenson, FNP
• Gary Guy Tuttle, D.D.S.
• Van Buren No1 Inc (Riverways Manor)
• Van Buren R-1 School

• Primary Care Clinic/Center in Van Buren, MO
• Providers in Van Buren, MO by specialty
• Primary Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.