Southeast Missouri Hospital Physicians LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLC

Doing business as

Southeast Primary Care - Broadway

Practice address

1723 Broadway St
Suite 205
Cape Girardeau, MO 63701-4566

Phone

(573) 331-7930

NPI assigned

Mar 8, 2011

Organization subpart

Yes

Parent organization

SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLCAs reported in NPPES

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

Authorized official

Name

Hubert King

Title

Vice Pres Cfo

Phone

(573) 334-4822

Specialties & licenses 1

Addresses

Other names 1

• Southeast Primary Care - Broadway Doing business as

Part of

Southeast Missouri Hos

Member of 1

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

• Southeast Hospital

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

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1780982215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 BROADWAY ST",
            "address_2": "SUITE 205",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014566",
            "telephone_number": "573-331-7930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 BROADWAY ST",
            "address_2": "SUITE 205",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014566",
            "telephone_number": "573-331-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLC",
        "enumeration_date": "2011-03-08",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "HUBERT",
        "authorized_official_title_or_position": "VICE PRES CFO",
        "authorized_official_telephone_number": "573-334-4822"
    },
    "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 - Broadway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southeast Missouri Anesthesia Services, LLC
• Southeast Missouri Area Agency on Aging, Inc.
• Southeast Missouri Area Agency on Aging, Inc.
• Southeast Missouri Hospital Physicians LLC
• Southeast Missouri Hospital Physicians LLC
• Southeast Missouri Hospital Physicians, LLC
• Southeast Missouri Oral & Maxillofacial Surgery
• Southeast Missouri State University
• Southeast Missouri State University
• Southeast Missouri State University

• Rural Health Clinic/Center in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Rural Health Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; 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.