State of Missouri
NPI 1740560580ActiveOrganization· Family Medicine· Poplar Bluff, MO
Family Medicine in Poplar Bluff, Missouri, registered in NPPES in August 2011, part of State of Missouri. The authorized official on file is Molly Jane Boeckmann, Director Of Administrative Services.
Overview
| NPI | 1740560580 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | State of Missouri |
| NPI issued | Aug 25, 2011 |
| Last updated in NPPES | Oct 15, 2020 |
| Certified by provider | Oct 15, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Emergency Medicine | 207P00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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