HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC (NPI# 1063431575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063431575 |
| Entity Type | Organization |
| Organization Name | HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC |
| Other Organization Name | CANTON/LAGRANGE FAMILY PRACTICE |
| Practice Address |
1802 Elm St Canton MO 63435-1694 |
| Mailing Address |
6500 Hospital Dr Hannibal MO 63401-6890 |
| Practice Telephone | 5736554891 |
| Practice Fax Number | 5732885361 |
| Mailing Telephone | 5732213415 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2014-05-09 |
| Authorized Official Name | ROGER J DIX (CFO) |
| Authorized Official Telephone | 5734061609 |
| Is Organization Subpart | Y |
| Parent Organization Name | HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 590416004 | 05 |
| Other Name | Type Code |
|---|---|
| Canton/LaGrange Family Practice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316452295 | Hannibal Regional Healthcare System, Inc | Hospice Care, Community Based | 6401 Hwy Mm, Hannibal, MO 63401 | 2017-12-13 |
| 1992726731 | Hannibal Regional Healthcare System, Inc | Home Health | 4601 Highway Mm, Hannibal, MO 63401-6918 | 2006-07-21 |
| 1700806130 | Hannibal Regional Healthcare System, Inc | Clinic/Center | #8 Town Center Drive, Bowling Green, MO 63334-0000 | 2006-07-20 |
| 1912926429 | Hannibal Regional Healthcare System, Inc | Clinic/Center | 821 Us Highway 24 and 36 E, Monroe City, MO 63456-1470 | 2006-07-18 |
| 1083134951 | Hannibal Regional Healthcare System, Inc | Clinic/Center | 1611 S Baltimore St, Kirksville, MO 63501-4518 | 2017-06-22 |
| 1154851228 | Hannibal Regional Healthcare System, Inc | Clinic/Center | 29934 July Rd, La Plata, MO 63549-3129 | 2017-06-12 |
| 1942730015 | Hannibal Regional Healthcare System, Inc | Clinic/Center | 1000 W Washington St, Lancaster, MO 63548-9038 | 2017-06-12 |
| 1447789300 | Hannibal Regional Healthcare System, Inc | Family Medicine | 1611 S Baltimore St, Kirksville, MO 63501-4518 | 2017-06-05 |
| 1033669353 | Hannibal Regional Healthcare System, Inc | Clinic/Center | 6500 Hospital Dr, Hannibal, MO 63401-6890 | 2016-10-11 |
| 1134311392 | Hannibal Regional Healthcare System, Inc | Clinic/Center | 6500 Hospital Drive, Hannibal, MO 63401-1239 | 2007-08-13 |
| Street Address |
1802 ELM ST |
| City | CANTON |
| State | MO |
| Zip Code | 63435-1694 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578578316 | Connie Marie Dochterman | Nurse Practitioner | 1802 Elm St, Canton-lagrange Family Practice, Canton, MO 63435-1694 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104009984 | Champ Clark Todd | Dentist | 412 Clark St, Canton, MO 63435 | 2007-12-14 |
| 1174688618 | Kenneth J Oliver | Counselor | 800 Hampton Ln, Canton, MO 63435-1032 | 2006-12-26 |
| 1013227925 | Gregory Leo Collier | Chiropractor | 705 College St, Canton, MO 63435-1236 | 2010-10-13 |
| 1497253066 | Christe Anne Thomas | Specialist/Technologist | 1 College Hl # 133, Canton, MO 63435-1257 | 2018-01-29 |
| 1285059386 | Michael James Schwarzer | Specialist/Technologist | 1 College Hl, Canton, MO 63435-1257 | 2014-02-26 |
| 1346871936 | Stormy Leeann Simons | Student in an Organized Health Care Education/Training Program | 1 College Hl, Canton, MO 63435-1257 | 2020-02-01 |
| 1275181018 | Thomas Greene | Student in an Organized Health Care Education/Training Program | 1 College Hl, Canton, MO 63435-1257 | 2019-08-26 |
| 1770085201 | Daniel Kevin Fohey | Specialist/Technologist | 1 College Hl, Canton, MO 63435-1257 | 2018-02-28 |
| 1104327766 | Makkel Marie Parrott | Specialist/Technologist | 1 College Hl, Canton, MO 63435-1257 | 2018-02-27 |
| 1467952754 | Kirby Alana Mcclain | Specialist/Technologist | 1 College Hl, Canton, MO 63435-1257 | 2018-02-14 |
| Find all providers in zip 63435 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902870439 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 1100 E Outer Rd S Ste 4, Canton, MO 63435-1702 | 2006-02-13 |
| 1124634175 | Claxton-hepburn Medical Center | Clinic/Center | 39 W Main St, Canton, NY 13617-1358 | 2020-09-16 |
| 1134313083 | Christus Trinity Clinic | Clinic/Center | 18780 Interstate 20, Canton, TX 75103-3593 | 2007-09-04 |
| 1932144243 | Psp Medical Clinic LLC | Clinic/Center | 1171 Hart St, Canton, MS 39046-4805 | 2006-06-19 |
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|---|---|---|---|---|
| 1871102137 | Washington County Memorial Hospital | Clinic/Center | 14206 Hwy C, Belgrade, MO 63622 | 2020-07-23 |
| 1891325072 | Scotland County Memorial Hospital | Clinic/Center | 55682 State Highway 6 Ste A, Edina, MO 63537-4268 | 2020-01-16 |
| 1639736457 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 800 Us Highway 61, New Madrid, MO 63869-1106 | 2019-05-28 |
| 1134633456 | Pike County Memorial Hospital | Clinic/Center | 1420 S Business 61 Unit Fde, Bowling Green, MO 63334-5230 | 2017-11-22 |
| 1720505894 | Perry County Health System | Clinic/Center | 210 Hospital Ln Ste 202, Perryville, MO 63775-4200 | 2017-08-29 |
| 1427572007 | Missouri Delta Medical Center | Clinic/Center | 209 W Yoakum Ave, Chaffee, MO 63740-1138 | 2017-07-26 |
| 1790213676 | Jackson Primary Care LLC | Clinic/Center | 2685 E Main St Ste A, Jackson, MO 63755-2474 | 2017-05-23 |
| 1972050581 | Sgoh Acquisition, Inc. | Clinic/Center | 912b State Highway 59, Goodman, MO 64843-8252 | 2016-09-01 |
| 1144605312 | Nevada City Hospital | Clinic/Center | 627 S Ash St Ste B, Nevada, MO 64772 | 2015-07-29 |
| 1669856829 | Ssm Regional Health Services | Clinic/Center | 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 | 2015-07-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.