SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLC NPI 1558311522

NPI Information

NPI: 1558311522
Provider Name: SOUTHEAST MISSOURI HOSPITAL PHYSICIANS, LLC

Doing Business As: MERCY CLINIC SOUTHEAST

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1701 LACEY ST
CAPE GIRARDEAU, MO
ZIP 63701
Phone: (573) 331-6880
Get Directions

SOUTHEAST MISSOURI HOSPITAL PHYSICIANS, LLC is a family medicine in Cape Girardeau, MO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SOUTHEAST MISSOURI HOSPITAL PHYSICIANS, LLC NPI is 1558311522. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mercy Clinic Southeast.

The provider's business location address is:

1701 LACEY ST
CAPE GIRARDEAU, MO
ZIP 63701-230
Phone: (573) 331-6880
Fax: (573) 331-6887

The provider's authorized official is Krista Berry .
The authorized official title is Cfo and has the following contact phone number (573) 331-6028.

The enumeration date for this NPI number is 5/11/2006 and was last updated on 1/13/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	No
2	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	No
3	207RG0100X	Internal Medicine	Gastroenterology	No
4	207RH0003X	Internal Medicine	Hematology & Oncology	No
5	207RP1001X	Internal Medicine	Pulmonary Disease	No
6	207V00000X	Obstetrics & Gynecology		No
7	208M00000X	Hospitalist		No
8	207VM0101X	Obstetrics & Gynecology	Maternal & Fetal Medicine	No
9	367500000X	Nurse Anesthetist, Certified Registered		No
10	207W00000X	Ophthalmology		No
11	2080N0001X	Pediatrics	Neonatal-Perinatal Medicine	No
12	208100000X	Physical Medicine & Rehabilitation		No
13	2084N0400X	Psychiatry & Neurology	Neurology	No
14	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery)		No
15	207Q00000X	Family Medicine		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	505394007	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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