MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOME (NPI# 1225104045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225104045 |
| Entity Type | Organization |
| Organization Name | MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOME |
| Other Organization Name | MADISON MEDICAL CENTER |
| Practice Address |
611 West Main Street Fredericktown MO 63645 |
| Mailing Address |
Po Box 431 611 West Main Street Fredericktown MO 63645 |
| Practice Telephone | 5737833341 |
| Practice Fax Number | 5737831096 |
| Mailing Telephone | 5737833341 |
| Mailing Fax Number | 5737831096 |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. LISA MARIE TWIDWELL (CFO) |
| Authorized Official Telephone | 5737833341 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 376J00000X | Homemaker | 25619 | MO | Nursing Service Related Providers |
| Other Name | Type Code |
|---|---|
| Madison Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003983859 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Pharmacy | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-29 |
| 1851467674 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Technician | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1306912134 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Ambulance | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| Street Address |
611 WEST MAIN STREET |
| City | FREDERICKTOWN |
| State | MO |
| Zip Code | 63645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467539031 | Madison Medical Center Stockhoff Memorial Nursing Home | Clinic/Center | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-01 |
| 1235392309 | Humberto Jose Olivero Lara | Family Medicine | 611 West Main Street, Fredericktown, MO 63645 | 2008-07-08 |
| 1043490857 | Julie Marie Buford | Nurse Practitioner | 611 West Main Street, Suite E, Fredericktown, MO 63645-1111 | 2007-11-08 |
| 1003983859 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Pharmacy | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-29 |
| 1750457586 | Madison Medical Center Stockhoff Memorial Nursing Home | Home Health | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1316013139 | Madison Medical Center Stockhoff Memorial Nursing Home | Medicare Defined Swing Bed Unit | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1851467674 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Technician | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1306912134 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Ambulance | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1215003041 | Madison Medical Center Stockhoff Memorial Nursing Home | Nursing Facility/Intermediate Care Facility | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093193880 | Emily Engers | Counselor | 206 W Marvin Ave, Fredericktown, MO 63645 | 2015-05-12 |
| 1871823955 | Covenant Care Services, LLC | Custodial Care Facility | 1610 W. Hwy 72, Fredericktown, MO 63645 | 2010-01-12 |
| 1518110279 | East Missouri Action Agency, Inc. | Clinic/Center | 806 West College Rd, Fredericktown, MO 63645 | 2008-10-28 |
| 1679737324 | Linda Carole Cravens | Dentist | 731 W Main St, Guy A Walker Dds, Fredericktown, MO 63645 | 2008-07-11 |
| 1629286976 | Community Health Care Associates, Inc | Social Worker | 735 West Main, Fredericktown, MO 63645 | 2007-05-18 |
| 1487749537 | Covenant Care Services, LLC | Registered Nurse | 120 S. Mine Lamotte, Fredericktown, MO 63645 | 2006-10-04 |
| 1215577945 | Modern Mental Health | Community/Behavioral Health | 151 South Main Street, Suite B, Fredericktown, MO 63645 | 2020-01-10 |
| 1619081593 | Angela R Menz | Nurse Practitioner | 611 W Main St, Fredericktown, MO 63645 | 2006-08-18 |
| 1811439227 | Bali Rae Hoover-richardson | Counselor | 1800 County Road 257, Fredericktown, MO 63645-0025 | 2016-11-16 |
| 1154673887 | Wagner Residential Care Inc | Assisted Living Facility | 320 N Chamber Dr, Fredericktown, MO 63645-0320 | 2012-10-04 |
| Find all providers in zip 63645 | ||||
| Taxonomy Code | 376J00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Homemaker |
| An individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly responsible for these activities is temporarily absent or unable to provide for himself. Homemakers must meet the state defined training standards. |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840360 | New Heights Homehealth Care, LLC | Homemaker | 4435 N Highway 67, Florissant, MO 63034-2831 | 2020-10-28 |
| 1104426659 | Midwest Home Health Care, Inc. | Homemaker | 1 W Armour Blvd Ste 101, Kansas City, MO 64111-2087 | 2020-10-26 |
| 1770199655 | Brittny Lynn Cockrell | Homemaker | 1105 Borden Dr, Florissant, MO 63031-1301 | 2020-09-16 |
| 1831717339 | Shantell Small | Homemaker | 1355 Taos Dr, Saint Louis, MO 63138-2317 | 2020-07-10 |
| 1942820063 | Loving Hearts Home Care LLC | Homemaker | 1409 Washington Ave Ste 416, Saint Louis, MO 63103-1917 | 2020-04-18 |
| 1760018436 | Nana and Jack's In-home Healthcare,llc | Homemaker | 1409 Washington Ave Ste 419, Saint Louis, MO 63103-1917 | 2020-03-13 |
| 1740812890 | Rotha Montez Perkins | Homemaker | 6815 Askew Ave, Kansas City, MO 64132-3017 | 2020-02-06 |
| 1447890413 | Charlene Coates | Homemaker | 9516 Drury Ave Apt 108, Kansas City, MO 64137-1234 | 2020-01-08 |
| 1881246056 | Reliable Home Health Service LLC | Homemaker | 2126 Woodson Rd, Saint Louis, MO 63114-5616 | 2019-07-09 |
| 1891257721 | Erica Ray | Homemaker | 1454 Hogan St, Saint Louis, MO 63106-4733 | 2019-04-01 |
| Find all providers with the same taxonomy | ||||
| City | FREDERICKTOWN |
| Zip Code | 63645 |
Please comment or provide details below to improve the information on MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOME.
| 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.