| Ssm Regional Health Services | |
|
875 State Route 5 Tipton MO 65081-8441 | |
| (660) 433-5541 | |
| (660) 433-5717 |
| Full Name | Ssm Regional Health Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 875 State Route 5, Tipton, Missouri |
| Authorized Official Name and Position | Shasta Rene Manuel (REGIONAL VICE PRESIDENT FINANCE/CFO) |
| Authorized Official Contact | 4052727282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ssm Regional Health Services Po Box 1027 Jefferson City MO 65102-1027 Ph: (573) 681-3767 | Ssm Regional Health Services 875 State Route 5 Tipton MO 65081-8441 Ph: (660) 433-5541 |
| NPI Number | 1588601777 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 05/13/2025 |
| Medicare PECOS PAC ID | 8921917352 |
|---|---|
| Medicare Enrollment ID | O20041105000902 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588601777 | NPI | - | NPPES |
| 503469108 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Gary Baskett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922039817 PECOS PAC ID: 0345277141 Enrollment ID: I20050725000001 |
| Provider Name | Garry D Pearson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629011812 PECOS PAC ID: 3274630629 Enrollment ID: I20070518000210 |
| Provider Name | Christine M Hurt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326086752 PECOS PAC ID: 1557444767 Enrollment ID: I20080212000175 |
| Provider Name | Paul E Burris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699100255 PECOS PAC ID: 4486881943 Enrollment ID: I20140721001904 |
| Provider Name | Christopher A Paynter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760749428 PECOS PAC ID: 1153634795 Enrollment ID: I20150724011839 |
| Provider Name | Nathan T Kenyon |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1851651657 PECOS PAC ID: 3274768494 Enrollment ID: I20170714002288 |
| Provider Name | Michelle Leigh Felten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679045595 PECOS PAC ID: 6305170234 Enrollment ID: I20190627000466 |
| Provider Name | Renee Jean Scherr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386104818 PECOS PAC ID: 4587075296 Enrollment ID: I20201202001306 |
| Provider Name | Whitney N Bahner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326735481 PECOS PAC ID: 7012372659 Enrollment ID: I20230503002277 |