Show Me State Infusion Clinic, LLC

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

SHOW ME STATE INFUSION CLINIC, LLC

Practice address

1704 Broadway St # Unite104
Cape Girardeau, MO 63701-4580

Phone

(573) 307-9070

NPI assigned

Feb 23, 2024

Organization subpart

No

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

Authorized official

Name

Ross Vogel

Title

Owner

Phone

(573) 307-9070

Specialties & licenses 1

Addresses

Other names 1

• Show Me State Vital Care Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael R Freeman, M.D.

  • Gastroenterology Physician
  • Cape Girardeau, MO
  • NPI 1851361455
  Medicare reassignment NPD

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1952167355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 BROADWAY ST # UNITE104",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014580",
            "telephone_number": "573-307-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 BROADWAY ST # UNITE104",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014580",
            "telephone_number": "573-307-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOW ME STATE INFUSION CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "VOGEL",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-307-9070"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Show Me State Vital Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• McKenzie Shirley
• Terry Lynn Shirley, LCSW
• Heather R Shirrell, PLPC
• Jessica Shirrell
• Nathan Michael Shortt
• Brittany L Showmaker
• Kayla Shuffit
• Ramya Siddaiah, BDS, MDS (OMFS), DDS
• Meleia Sides, MA, LPC, NCC
• Stanley Sides, M.D.

• Infusion Therapy Clinic/Center in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Infusion Therapy Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.