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

Q: What is Kirksville Missouri Hospital Company LLC's specialty?

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

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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

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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 Home State Health, Ambetter from Sunflower Health Plan and more.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 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.

Other Providers at the Same Location NPPES 6

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

KIRKSVILLE MISSOURI HOSPITAL COMPANY LLC

Clinic/Center (Rural Health)