BONNE TERRE HEALTH CLINIC LLC – Rural Health Clinic/Center, NPI 1104071935

BONNE TERRE HEALTH CLINIC LLC is a healthcare provider. based in Bonne terre, Missouri. specializing in Rural Health Clinic/Center. The organization holds a License No. 102387 (MO). The NPI Number for BONNE TERRE HEALTH CLINIC LLC is 1104071935

Main info

Organization
Name
BONNE TERRE HEALTH CLINIC LLC
NPI
1104071935
Phone
(573) 358-3343
Address
55 NESBIT DR
Authorized Official
MR. ANDREW JOHN NINICHUCK MEMBER M.D.
Enumeration Date
20 November 2008
Last Update Date
24 September 2009
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:17State licenses:1Digital endpointsOther names

Provider Addresses for BONNE TERRE HEALTH CLINIC LLC

  • 55 NESBIT DR

    BONNE TERRE, MO 636281353

    Phone: (573) 358-3343

    Fax: (573) 358-5458

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63628)

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Frequently asked questions

How do I look up BONNE TERRE HEALTH CLINIC LLC by NPI?
Use NPI 1104071935 when you need to reference BONNE TERRE HEALTH CLINIC LLC in forms, claims, or directories.
Is BONNE TERRE HEALTH CLINIC LLC active in the national directory?
BONNE TERRE HEALTH CLINIC LLC's public NPI profile is in an active state.
What field does BONNE TERRE HEALTH CLINIC LLC work in?
You can think of BONNE TERRE HEALTH CLINIC LLC as practicing within Rural Health Clinic/Center. Clinical services aligned with this taxonomy classification.
Where does public data place BONNE TERRE HEALTH CLINIC LLC?
The snapshot lists Bonne Terre, Missouri for BONNE TERRE HEALTH CLINIC LLC; download NPPES for the complete set.
What if Bonne Terre, Missouri seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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