MADISON MEDICAL CENTER STOCKHOFF MEMORIAL NURSING HOME (NPI# 1467539031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467539031 |
| Entity Type | Organization |
| Organization Name | MADISON MEDICAL CENTER STOCKHOFF MEMORIAL NURSING HOME |
| Other Organization Name | MADISON MEDICAL CENTER RHC |
| Practice Address |
611 West Main Street Fredericktown MO 63645 |
| Mailing Address |
611 W Main St Fredericktown MO 63645-1111 |
| Practice Telephone | 5737833341 |
| Practice Fax Number | 5737831096 |
| Mailing Telephone | 5737833341 |
| Mailing Fax Number | 5737831096 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2013-12-05 |
| 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 | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 590155107 | 05 |
| Other Name | Type Code |
|---|---|
| Madison Medical Center RHC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649357229 | Madison Medical Center Stockhoff Memorial Nursing Home | Clinic/Center | 200 St. Mary, Pilot Knob, MO 63663-0523 | 2006-11-01 |
| 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 |
| 1215003041 | Madison Medical Center Stockhoff Memorial Nursing Home | Nursing Facility/Intermediate Care Facility | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1720163025 | Madison Medical Center Stockhoff Memorial Nursing Home | General Acute Care Hospital | 611 W Main St, Fredericktown, MO 63645-1111 | 2006-10-26 |
| Street Address |
611 WEST MAIN STREET |
| City | FREDERICKTOWN |
| State | MO |
| Zip Code | 63645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831261601 | Chands' Medical Office of Fredericktown LLC | Clinic/Center | 101 N Chamber Dr, Fredericktown, MO 63645-7944 | 2006-11-15 |
| 1063517613 | Farmington Clinic Company LLC | Clinic/Center | 309 Garrett St, Fredericktown, MO 63645-1084 | 2006-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 | ||||
| City | FREDERICKTOWN |
| Zip Code | 63645 |
Please comment or provide details below to improve the information on MADISON MEDICAL CENTER 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.