PORTAGEVILLE FAMILY CLINIC
NPI 1780803916
Clinic/Center - Federally Qualified Health Center (FQHC) in Portageville, MO
About Portageville Family Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PORTAGEVILLE FAMILY CLINIC (NPI 1780803916) is a healthcare organization registered as a federally qualified health center (fqhc) in Portageville, Missouri and active in the NPI registry since April 2007. The organization lists Cheryl A White, Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Portageville Family Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
18Medicare enrollment records show 18 clinicians reassign Medicare billing to Portageville Family Clinic, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (18)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 1780803916. It was assigned to this organization in the NPPES registry on April 25, 2007. The provider is doing business as Portageville Family Clinic.
Where is Southeast Missouri Health Network located?
Southeast Missouri Health Network is located at 314 E Main St, Portageville, MO 63873. The listed phone number is (573) 379-5929.
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.
Is Southeast Missouri Health Network enrolled in Medicare?
Yes. Southeast Missouri Health Network is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southeast Missouri Health Network?
According to the CMS Revalidation Reassignment List (October 2026 release), 18 clinicians in 5 Medicare specialties reassign their Medicare billing to Southeast Missouri Health Network. 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 Nurse Practitioner (11), Family Practice (3) and Mental Health Counselor (2). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Southeast Missouri Health Network was last updated on March 7, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Portageville Family Clinic · NPI 1780803916
Federally Qualified Health Center (FQHC) organization in Portageville, Missouri. Organization record, active in the CMS NPPES registry since April 25, 2007.
## Identity
- **NPI:** 1780803916 (Entity type: Organization)
- **Enumerated:** April 25, 2007
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Southeast Missouri Health Network
- **Organization subpart:** Yes (part of Southeast Missouri Health Network)
- **Authorized official:** Cheryl White, CHIEF EXECUTIVE OFFICER
## Practice location
- **Address:** 314 E MAIN ST, Portageville, MO 63873-1616
- **Phone:** (573) 379-5929 · **Fax:** (573) 379-5912
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 18 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (11), Family Practice (3), Mental Health Counselor (2) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 7, 2011
- **Other identifiers:** Medicaid 503973901 (MO); Other 000010626 (MO); Medicare OSCAR/certification 261849 (MO)
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Source: [NPI Profile](https://npiprofile.com/npi/1780803916) · Data from the CMS NPPES public registry.