1. Home
  2. Directory
  3. Missouri
  4. Caruthersville
  5. Clinic Center
  6. NPI Profile

CARUTHERSVILLE DENTAL CENTER
NPI 1053700435
Clinic/Center - Federally Qualified Health Center (FQHC) in Caruthersville, MO

Active since January 22, 2015CLIA 26D0687480 · Accreditation
109 E 5TH ST, CARUTHERSVILLE, MO 63830(573) 359-9803(573) 359-0990 Get Directions Write a Review

NPPES record last updated: January 17, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Caruthersville Dental Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARUTHERSVILLE DENTAL CENTER (NPI 1053700435) is a healthcare organization registered as a federally qualified health center (fqhc) in Caruthersville, Missouri and active in the NPI registry since January 2015. The organization holds an CLIA Accreditation certificate valid through January 26, 2028 and lists Christopher Jones, Ceo, as its authorized official.

NPPES Registry Identity

NPI1053700435
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameSOUTHEAST MISSOURI HEALTH NETWORK
Location Address109 E 5TH STCaruthersville, MO 63830-1417
Mailing Address6738 State Highway 77Benton, MO 63736-8238 · (573) 313-2500 · Fax (573) 313-2505
Phone(573) 359-9803
Fax(573) 359-0990
Organization SubpartNo
Authorized OfficialChristopher JonesCeo · (573) 748-2404
Enumeration DateJanuary 22, 2015
Last NPPES UpdateJanuary 17, 2025
NPPES CertifiedJanuary 17, 2025
✔ NPI 1053700435 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedDentist · General PracticeTaxonomy 1223G0001X
109 E 5TH ST, Caruthersville, MO 63830
Open in Google Maps ↗

Other Names 1

Doing Business AsCaruthersville Dental Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 26D0687480

Southeast Missouri Health Network · Benton, MO
Active · expires Jan 26, 2028
CLIA Number26D0687480
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJanuary 27, 2026
Certificate Expiration DateJanuary 26, 2028
Laboratory DirectorDaniel Domjan
Laboratory Phone(573) 313-2377
Laboratory LocationSoutheast Missouri Health Network6724 State Highway 77, Benton, MO 63736
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMBERLY D PRITCHARD LPC, NCC
Counselor
109 E 5TH ST
CARUTHERSVILLE, MO 63830
Pemiscot County (573) 359-9803
ADELINE HUBBARD DDS
Dentist
109 E 5TH ST
CARUTHERSVILLE, MO 63830
Pemiscot County (573) 922-5007
MRS. REBECCA VANESSA YOUNG FNP
Nurse Practitioner (Family)
109 E 5TH ST
CARUTHERSVILLE, MO 63830
Pemiscot County (573) 359-9803
SUMMER ALEXANDER NP
Nurse Practitioner (Family)
109 E 5TH ST
CARUTHERSVILLE, MO 63830
Pemiscot County (573) 359-9803
CLARENCE J WILSON JR DDS INC
Dentist (General Practice)
109 E 5TH ST
CORUTHERSVILLE, MO 63830
Pemiscot County (573) 333-1550

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeast Missouri Health Network's NPI number?

The NPI number for Southeast Missouri Health Network is 1053700435. It was assigned to this organization in the NPPES registry on January 22, 2015. The provider is doing business as Caruthersville Dental Center.

Where is Southeast Missouri Health Network located?

Southeast Missouri Health Network is located at 109 E 5th St, Caruthersville, MO 63830. The listed phone number is (573) 359-9803.

What is Southeast Missouri Health Network's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Southeast Missouri Health Network hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 26D0687480) is associated with this NPI, valid through January 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Southeast Missouri Health Network accept?

Health plans from UnitedHealthcare list Southeast Missouri Health Network as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southeast Missouri Health Network was last updated on January 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.