MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOME (NPI# 1306912134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306912134 |
| 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 | 3416L0300X |
Ambulance Specialization: Land Transport |
123005 | MO | Transportation Services |
| 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 |
| 1225104045 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Homemaker | 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 |
| 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 |
| 1225104045 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Homemaker | 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 |
| 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 | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003114521 | Fredericktown Community Joint Emergency Ambulance District | Ambulance | 139 Columbus Rd, Fredericktown, OH 43019-9120 | 2011-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285275123 | Odessa Fire & Rescue Protection District | Ambulance | 301 W Dryden St, Odessa, MO 64076-1218 | 2019-10-02 |
| 1407404098 | County of Jackson Raytown Fire Protection District | Ambulance | 6020 Raytown Trfy, Raytown, MO 64133-3856 | 2019-08-28 |
| 1801268537 | New Image Nemt Ambulance Services | Ambulance | 4960 E Linwood Blvd, Kansas City, MO 64128-1801 | 2015-10-21 |
| 1013250620 | Pettis County Ambulance District | Ambulance | 210 W 4th St, Sedalia, MO 65301 | 2013-04-02 |
| 1407192404 | Inter City Fire Protection District | Ambulance | 1702 Blue Ridge Blvd, Blue Summit, MO 64126-3016 | 2012-12-19 |
| 1356692750 | Central Jackson County Fire Protection District | Ambulance | 805 Ne Jefferson St, Blue Springs, MO 64014 | 2012-09-25 |
| 1508115775 | Butler County Ems LLC | Ambulance | 4005 South Westwood Blvd, Poplar Bluff, MO 63901 | 2012-09-04 |
| 1639439961 | St. James Ambulance District | Ambulance | 203 S Louise Ave, Saint James, MO 65559-1744 | 2012-05-21 |
| 1265702971 | Central Cass County Fire & Ambulance Protection District | Ambulance | 2507 Se Outer Rd, Harrisonville, MO 64701-6366 | 2012-01-11 |
| 1376845008 | Regional Emergency Medical Services Authority | Ambulance | 5010 Frederick Ave, Saint Joseph, MO 64506-3248 | 2010-12-01 |
| 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.