1. Home
  2. Directory
  3. Missouri
  4. Kirksville
  5. Family Medicine
  6. NPI Profile

NORTHEAST REGIONAL MEDICAL GROUP
NPI 1336491448
Family Medicine in Kirksville, MO

Active since October 12, 2012CLIA 26D1054540 · Waiver
1607 S BALTIMORE ST, KIRKSVILLE, MO 63501(660) 627-3363(660) 627-3367 Get Directions Write a Review

NPPES record last updated: December 4, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Northeast Regional Medical Group NPPES

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

NORTHEAST REGIONAL MEDICAL GROUP (NPI 1336491448) is a healthcare organization registered as a family medicine in Kirksville, Missouri and active in the NPI registry since October 2012. The organization holds a CLIA Waiver certificate valid through May 23, 2028 and lists Brian Peoples, Vice-president, as its authorized official.

NPPES Registry Identity

NPI1336491448
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameKIRKSVILLE MISSOURI HOSPITAL COMPANY LLC
Location Address1607 S BALTIMORE STKirksville, MO 63501-4536
Mailing AddressPo Box 689022Franklin, TN 37068-9022 · (615) 465-7000 · Fax (615) 465-3007
Phone(660) 627-3363
Fax(660) 627-3367
Organization SubpartYes
Authorized OfficialBrian PeoplesVice-president · (615) 465-7585
Enumeration DateOctober 12, 2012
Last NPPES UpdateDecember 4, 2012
✔ NPI 1336491448 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X
1607 S BALTIMORE ST, Kirksville, MO 63501
Open in Google Maps ↗

Other Names 1

Doing Business AsNortheast Regional Medical Group

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Northeast Regional Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Northeast Regional Medical Group, which bills Medicare for the services they deliver. Of these, 8 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Valena Fiscus, D.O.
Internal Medicine
NPI 1386087757
800 W JEFFERSON ST
Kirksville, MO 63501
(660) 626-2223
✔ PECOS✔ Accepts Medicare0.8 mi
Jacqueline Kirkpatrick, FNP-BC
Nurse Practitioner
NPI 1831969526
315 S OSTEOPATHY AVE
Kirksville, MO 63501
(660) 785-1000
✔ PECOS✔ Accepts Medicare1.2 mi
Melissa Mann, DO
Internal Medicine
NPI 1730706243
315 S OSTEOPATHY AVE ATTN DME OFFICE
Kirksville, MO 63501
(515) 979-8442
✔ PECOS✔ Accepts Medicare1.5 mi
Tysen Petre, D.O.
Family Practice
NPI 1871642470
1611 S BALTIMORE ST
Kirksville, MO 63501
(660) 665-7575
✔ PECOS✔ Accepts Medicare1.9 mi
John Deleeuw, DO
Internal Medicine
NPI 1770590846
1607 S BALTIMORE ST
Kirksville, MO 63501
(660) 627-3363
✔ PECOS✔ Accepts Medicare1.9 mi
Kade Kinney, DO
Family Practice
NPI 1508598681
1607 S BALTIMORE ST
Kirksville, MO 63501
(660) 627-3363
✔ PECOS✔ Accepts Medicare1.9 mi
Nancy Rourke, CNP
Nurse Practitioner
NPI 1811615529
1607 S BALTIMORE ST
Kirksville, MO 63501
(660) 627-3363
✔ PECOS✔ Accepts Medicare1.9 mi
David Spencer, DO
Internal Medicine
NPI 1154820157
1605 S BALTIMORE ST STE B
Kirksville, MO 63501
(660) 665-3599
✔ PECOS✔ Accepts Medicare1.9 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Waiver 26D1054540

Northeast Regional Medical Group · Kirksville, MO
Active · expires May 23, 2028
CLIA Number26D1054540
Laboratory TypePhysician Office
Certificate Effective DateMay 24, 2026
Certificate Expiration DateMay 23, 2028
Laboratory DirectorMelissa Mann
Laboratory Phone(660) 627-3363
Laboratory LocationNortheast Regional Medical Group1607 South Baltimore, Kirksville, MO 63501
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Kirksville Missouri Hospital Company LLC's NPI number?

The NPI number for Kirksville Missouri Hospital Company LLC is 1336491448. It was assigned to this organization in the NPPES registry on October 12, 2012. The provider is doing business as Northeast Regional Medical Group.

Where is Kirksville Missouri Hospital Company LLC located?

Kirksville Missouri Hospital Company LLC is located at 1607 S Baltimore St, Kirksville, MO 63501. The listed phone number is (660) 627-3363.

What is Kirksville Missouri Hospital Company LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kirksville Missouri Hospital Company LLC enrolled in Medicare?

Yes. Kirksville Missouri Hospital Company LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kirksville Missouri Hospital Company LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 3 Medicare specialties reassign their Medicare billing to Kirksville Missouri Hospital Company LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (4), Family Practice (2) and Nurse Practitioner (2). Of these, 8 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Kirksville Missouri Hospital Company LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D1054540) is associated with this NPI, valid through May 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kirksville Missouri Hospital Company LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 2 other insurers list Kirksville Missouri Hospital Company LLC 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 Kirksville Missouri Hospital Company LLC was last updated on December 4, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.