SOUTHEAST MISSOURI HEALTH NETWORK NPI 1609095975

NPI Information

  • NPI: 1609095975
  • Provider Name: SOUTHEAST MISSOURI HEALTH NETWORK
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Other Name: NEW MADRID MEDICAL CENTER
  • CLIA Number: 26D2152024
  • Address: 655 HIGHWAY 61
    NEW MADRID, MO
    ZIP 63869
  • Phone: (573) 748-2592

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NPI Details

SOUTHEAST MISSOURI HEALTH NETWORK is a federally qualified health center (fqhc) clinic center in New Madrid, MO. SOUTHEAST MISSOURI HEALTH NETWORK NPI is 1609095975. The provider is registered as an organization entity type.
The provider Other Name Is New Madrid Medical Center.

The provider's business location address is:

655 HIGHWAY 61
NEW MADRID, MO
ZIP 63869-733
Phone: (573) 748-2592
Fax: (573) 748-2673

The provider's authorized official is Sara Deane .
The authorized official title is Chief Financial Officer and has the following contact phone number (573) 313-2500.

The CLIA number assigned to this NPI record is 26D2152024 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/25/2007 and was last updated on 12/12/2024.

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 License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)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
1500704010MEDICAIDMISSOURI

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: 11/21/2025

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