NPIMap

Organization Active NPI

Southeast Missouri Behavioral Health Inc

  • Community/Behavioral Health Agency
  • Farmington, MO
National Provider Identifier
1982875407
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SOUTHEAST MISSOURI BEHAVIORAL HEALTH INC
Practice address
5536 Hwy 32
Farmington, MO 63640-7357
Phone
(573) 431-3341
Fax
(573) 431-6580
NPI assigned
Mar 13, 2008
Last updated
Mar 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Authorized official

Name
Dr. Barron E Pratte, PH.D.
Title
President/Ceo
Phone
(573) 431-0554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

5536 Hwy 32
Farmington, MO 63640-7357

Mailing address

PO Box 506
Park Hills, MO 63601-0506
Phone (573) 431-0554

Other identifiers 1

IdentifierTypeStateIssuer
503839409MedicaidMO

Other names 1

  • Southeast Missouri Community Treatment Center Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050503000908 MO Part B Supplier - Clinic/Group Practice 7012957616 Receives reassigned benefits from 15 practitioners
Practice locations: Steelville, MO; Salem, MO; Rolla, MO; Poplar Bluff, MO; Piedmont, MO; Houston, MO; Farmington, MO; Cadet, MO

National Provider Directory

National Provider Directory
Tax ID family
Southeast Missouri Behavioral Health15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

312 N Franklin St
Cuba, MO 65453
Phone (573) 677-0262

1565 Sainte Genevieve Ave
Farmington, MO 63640
Phone (573) 756-5749

308 Vine St
Poplar Bluff, MO 63901
Phone (573) 686-5090

1051 Kingshighway St
Rolla, MO 65401
Phone (573) 364-8511

1051 Kingshighway St
Ste 5
Rolla, MO 65401
Phone (573) 364-8511

200 N Washington St
Salem, MO 65560
Phone (573) 729-4723

203 N Grand St
Ste 429
Salem, MO 65560

402 N Grand St
Salem, MO 65560
Phone (573) 729-8452

2885 W Battlefield St
Springfield, MO 65807
Phone (417) 761-5214

Practitioners & affiliated clinicians

Practitioners 91

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 91

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1982875407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 506",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636010506",
            "telephone_number": "573-431-0554",
            "fax_number": "573-431-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5536 HWY 32",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636407357",
            "telephone_number": "573-431-3341",
            "fax_number": "573-431-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MISSOURI BEHAVIORAL HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "PRATTE",
        "authorized_official_first_name": "BARRON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "573-431-0554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "503839409",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Missouri Community Treatment Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Farmington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.