NPIMap

Organization Active NPI

Southeast Health Center of Stoddard County, LLC

  • Home Health Agency
  • Dexter, MO
National Provider Identifier
1801891015
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
760 Issued in MO
Legal business name
SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC
Doing business as
Southeast Home Health of Dexter
Practice address
1300 N One Mile Rd
Suite 7
Dexter, MO 63841-1042
Phone
(573) 624-3511
Fax
(573) 624-5839
NPI assigned
Jun 15, 2005
Organization subpart
Yes
Parent organization
SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

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

Authorized official

Name
Mrs. Paula Harris
Title
VP Regional Operations
Phone
(573) 778-0020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 760 MO Primary

Addresses

Primary practice location

1300 N One Mile Rd
Suite 7
Dexter, MO 63841-1042

Mailing address

1300 N One Mile Rd
Suite 7
Dexter, MO 63841-1042
Phone (573) 624-3511

Other identifiers 2

IdentifierTypeStateIssuer
54OtherMOBLUECROSS/BLUESHIELD
580722601MedicaidMO

Other names 1

  • Southeast Home Health of Dexter Doing business as

National Provider Directory

National Provider Directory
Part of
Southeast Health Center of Stoddard County LLC

Member of 2

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

Locations

1300 N One Mile Rd
Ste 7
Dexter, MO 63841
Phone (573) 624-3511

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383177600000",
    "number": "1801891015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N ONE MILE RD",
            "address_2": "SUITE 7",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638411042",
            "telephone_number": "573-624-3511",
            "fax_number": "573-624-5839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N ONE MILE RD",
            "address_2": "SUITE 7",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638411042",
            "telephone_number": "573-624-3511",
            "fax_number": "573-624-5839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEAST HEALTH  CENTER OF STODDARD COUNTY, LLC",
        "enumeration_date": "2005-06-15",
        "last_updated": "2013-10-31",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "VP REGIONAL OPERATIONS",
        "authorized_official_telephone_number": "573-778-0020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "54",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "580722601",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Home Health of Dexter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dexter, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; 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.