HANNIBAL REGIONAL HOSPITAL (NPI# 1174585103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174585103 |
| Entity Type | Organization |
| Organization Name | HANNIBAL REGIONAL HOSPITAL |
| Practice Address |
188a Medical Dr Hannibal MO 63401-6877 |
| Mailing Address |
4537 W Ely Rd #804 Hannibal MO 63401-2546 |
| Practice Telephone | 5734060576 |
| Mailing Telephone | 5732483889 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. CAROL JACO (SR. VICE PRESIDENT OF PATIENT CARE) |
| Authorized Official Telephone | 5732485257 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2002030211 | MO | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073532560 | Hannibal Regional Hospital | Clinic/Center | 401 East Hwy 19, Center, MO 63436 | 2006-07-18 |
| 1225382435 | Hannibal Regional Hospital | Clinic/Center | 3145 Highway 61, Suite A, Hannibal, MO 63401-6588 | 2012-11-09 |
| 1922356765 | Hannibal Regional Hospital | Internal Medicine | 714 Medical Park Dr, Mexico, MO 65265-3726 | 2012-08-28 |
| 1245510221 | Hannibal Regional Hospital | Clinic/Center | 3650 Stardust Dr, Hannibal, MO 63401-2480 | 2011-08-23 |
| 1841579356 | Hannibal Regional Hospital | Eyewear Supplier (Equipment, not the service) | 101 E Washington St, Pittsfield, IL 62363-1436 | 2011-08-15 |
| 1508155888 | Hannibal Regional Hospital | Clinic/Center | 1 Northport Plz, Hannibal, MO 63401-2269 | 2011-04-07 |
| 1871892158 | Hannibal Regional Hospital | Eyewear Supplier (Equipment, not the service) | 1 Northport Plz, Hannibal, MO 63401-2269 | 2011-03-25 |
| 1417273749 | Hannibal Regional Hospital | Eyewear Supplier (Equipment, not the service) | 175 Shinn Ln, Hannibal, MO 63401-6754 | 2010-04-12 |
| 1861632226 | Hannibal Regional Hospital | Optometrist | 175 Shinn Ln, Hannibal, MO 63401-6754 | 2009-02-25 |
| 1457409518 | Hannibal Regional Hospital | General Acute Care Hospital | 6000 Hospital Drive, Hannibal, MO 63401 | 2007-01-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HANNIBAL REGIONAL HOSPITAL | 6000 Hospital Dr, Hannibal, MO 63401-6887 |
| Street Address |
188A MEDICAL DR |
| City | HANNIBAL |
| State | MO |
| Zip Code | 63401-6877 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871066746 | Macy Huber | Physical Therapist | 188a Medical Dr, Hannibal, MO 63401-6877 | 2019-01-03 |
| 1639655939 | Kathleen Crane | Physical Therapist | 188a Medical Dr, Hannibal, MO 63401-6877 | 2018-07-19 |
| 1063965390 | Brittany Albers | Physical Therapist | 188a Medical Dr, Hannibal, MO 63401-6877 | 2016-08-03 |
| 1104136027 | Jailynn Nicole Francisco | Physical Therapist | 188a Medical Dr, Hannibal, MO 63401-6877 | 2010-10-13 |
| 1952638694 | Rebecca Lynne Humphreys | Physical Therapist | 188a Medical Dr, Hannibal, MO 63401-6877 | 2009-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255981064 | Amanda Lynn Jennings | Nurse Practitioner | Hannibal Clinic, 100 Medical Drive, Hannibal, MO 63401 | 2019-09-13 |
| 1316452295 | Hannibal Regional Healthcare System, Inc | Hospice Care, Community Based | 6401 Hwy Mm, Hannibal, MO 63401 | 2017-12-13 |
| 1932614351 | Sidney M Johnson | Counselor | 1221 Broadway St, Hannibal, MO 63401 | 2017-12-07 |
| 1316467210 | Jessica Baker | Counselor | 4355 Paris Gravel Road, Hannibal, MO 63401 | 2017-06-21 |
| 1346787066 | Hands Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17 Settlerstrail, Hannibal, MO 63401 | 2017-01-20 |
| 1134571672 | Pamela Barrigar | Social Worker | 4600 Mcmasters Ave, Hannibal, MO 63401 | 2016-07-08 |
| 1639540677 | Jessica Murfin | Speech-Language Pathologist | 544 N Veterans Rd, Hannibal, MO 63401 | 2015-10-16 |
| 1366835639 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 8965 Highway 36 Ste 3, Hannibal, MO 63401 | 2015-03-11 |
| 1639324254 | Hannibal Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 118 Steam Boat Bend, Hannibal, MO 63401 | 2008-11-24 |
| 1780856112 | Barbara Belle Smith | Social Worker | 3700 Hwy Mm, Hannibal, MO 63401 | 2008-03-26 |
| Find all providers in zip 63401 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689095721 | Joshua Miley | Specialist/Technologist | 2800 Palmyra Rd, Hannibal, MO 63401-1940 | 2013-12-16 |
| 1902416696 | Kailee Ann O'laughlin | Specialist/Technologist | 2800 Palmyra Rd, Hannibal, MO 63401-1940 | 2020-08-06 |
| 1407307432 | Cherise Endres | Specialist/Technologist | 2800 Palmyra Rd, Hannibal, MO 63401-1940 | 2016-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051516 | Kangjun Lee | Specialist/Technologist | 901 S. National Ave., Springfield, MO 65897 | 2020-10-20 |
| 1114525631 | Kaylen A Howard | Specialist/Technologist | No, No, MO 63119 | 2020-10-16 |
| 1548868334 | Alexander Kenneth Hollingsworth | Specialist/Technologist | 1904 Franklin Ave, Lexington, MO 64067-1705 | 2020-10-13 |
| 1164020335 | Taylor Fumagalli | Specialist/Technologist | 1421 Woodstone Dr, Saint Charles, MO 63304-6866 | 2020-10-11 |
| 1265039192 | Carley M Swabby | Specialist/Technologist | 652 Bismark Ave, Saint Louis, MO 63119-1528 | 2020-10-05 |
| 1275144891 | Tiffany Hallacy | Specialist/Technologist | 5014 Walnut St Apt D, Kansas City, MO 64112-2641 | 2020-08-17 |
| 1306464011 | Dustin Flynn | Specialist/Technologist | 541 Huntley Heights Dr, Ballwin, MO 63021-5884 | 2020-07-09 |
| 1851916878 | Olivia Marie Bogolin | Specialist/Technologist | 111 Timber Trace Xing, Wentzville, MO 63385-2124 | 2020-06-15 |
| 1417571464 | Jessica Burgason | Specialist/Technologist | 24173 State Highway F, Kirksville, MO 63501-8009 | 2020-06-05 |
| 1225651664 | Ashley Marie Garlock | Specialist/Technologist | 1308 S Halliburton St, Kirksville, MO 63501-4456 | 2020-05-20 |
| 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.