Midwest Health Care, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

037135 Issued in MO

Legal business name

MIDWEST HEALTH CARE, LLC

Practice address

2350 Kanell Blvd
Poplar Bluff, MO 63901-4036

Phone

(573) 785-0188

Fax

(573) 785-7321

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jifi Jacob

Title

Manager

Phone

(618) 628-7671

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• The Cedargate Doing business as

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249257600000",
    "number": "1790805018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014036",
            "telephone_number": "573-785-0188",
            "fax_number": "573-785-7321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014036",
            "telephone_number": "573-785-0188",
            "fax_number": "573-785-7321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2009-08-03",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "JIFI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "618-628-7671",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "031347",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "037135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101482008",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Cedargate",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Martin H Michel, R.PH., M.B.A., C.D.E
• Michael G Michel, B.S., D.C.
• Mid-Land Anesthesia Associates
• Mid-South Health Clinic LLC
• Midwest Equipment SRV Systems LLC
• Midwest OB GYN of Missouri, L.L.C.
• Midwest OB GYN of Missouri, LLC
• Midwest Therapy Services
• Robert H Mielke, CRNA
• Tabitha Mikel

• Skilled Nursing Facility in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2009; 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.