PEMISCOT COUNTY MEMORIAL HOSPITAL (NPI# 1669493144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669493144 |
| Entity Type | Organization |
| Organization Name | PEMISCOT COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | CARUTHERSVILLE NURSING CENTER |
| Practice Address |
500 Truman Blvd Caruthersville MO 63830-1261 |
| Practice Telephone | 5733335150 |
| Practice Fax Number | 5733334580 |
| Mailing Telephone | 5733335150 |
| Mailing Fax Number | 5733334580 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2016-07-13 |
| Authorized Official Name | KERRY NOBLE (CFO) |
| Authorized Official Telephone | 5733593612 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | 032389 | MO | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 032389 | MO | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 101459006 | 05 |
| Other Name | Type Code |
|---|---|
| Caruthersville Nursing Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558514901 | Pemiscot County Memorial Hospital | Clinic/Center | 213 S Walnut St, Steele, MO 63877-1714 | 2008-10-29 |
| 1386807675 | Pemiscot County Memorial Hospital | Family Medicine | 946 East Reed St, Hayti, MO 63851 | 2008-07-07 |
| 1932372646 | Pemiscot County Memorial Hospital | Clinic/Center | 555 Virginia Ave, New Madrid, MO 63869 | 2008-04-03 |
| 1508078254 | Pemiscot County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 946 E Reed Street, Hayti, MO 63851-0489 | 2007-05-04 |
| 1437251634 | Pemiscot County Memorial Hospital | Clinic/Center | 106 West 12th St, Caruthersville, MO 63830 | 2006-09-01 |
| 1831689058 | Pemiscot County Memorial Hospital | Clinic/Center | 216 W Main St, Steele, MO 63877 | 2018-05-14 |
| 1124518451 | Pemiscot County Memorial Hospital | Clinic/Center | 100 S Main Street, Gideon, MO 63848 | 2018-05-11 |
| 1477091890 | Pemiscot County Memorial Hospital | Family Medicine | 105 E Washington St, Kennett, MO 63857-2041 | 2017-02-06 |
| 1841463551 | Pemiscot County Memorial Hospital | Clinic/Center | 1502 Ward Ave, Caruthersville, MO 63830-2571 | 2008-04-03 |
| 1710159314 | Pemiscot County Memorial Hospital | Psychiatric Unit | 946 E Reed St, Hayti, MO 63851-1243 | 2008-03-24 |
| Street Address |
500 TRUMAN BLVD |
| City | CARUTHERSVILLE |
| State | MO |
| Zip Code | 63830-1261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295242097 | Chelsea Lynn Hubbard | Speech-Language Pathologist | 500 Truman Blvd, Caruthersville, MO 63830-1261 | 2018-01-03 |
| 1457708018 | Caruthersville No 1 Inc | Skilled Nursing Facility | 500 Truman Blvd, Caruthersville, MO 63830-1261 | 2016-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689216400 | Jazmyne S Hall | Behavior Technician | 915 Highway 84, Caruthersville, MO 63830 | 2019-10-14 |
| 1134573017 | Nathan Straeter | Pharmacist | State Highway 84 West, Caruthersville, MO 63830 | 2016-04-18 |
| 1861805624 | Ashley Marie Ballard | Case Manager/Care Coordinator | 10 & Ward Suite C, Caruthersville, MO 63830 | 2014-06-09 |
| 1356764435 | Jena Payne | Case Manager/Care Coordinator | 10th Ward St, Caruthersville, MO 63830 | 2014-01-27 |
| 1619390705 | James Smith | Case Manager/Care Coordinator | 10th & Ward Suite B, Caruthersville, MO 63830 | 2014-01-27 |
| 1730501370 | Belinda Fields | Community Health Worker | 10th & Ward, C, Caruthersville, MO 63830 | 2014-01-16 |
| 1831387372 | T M Swinger & D V Mckillip, Ptr | Optometrist | 101 E. 10th St., Suite A, Caruthersville, MO 63830 | 2007-10-10 |
| 1437284635 | Terrence M Swinger | Optometrist | 101 E. Tenth St., Suite A, Caruthersville, MO 63830 | 2007-02-21 |
| 1114097581 | John D Gardner | Dentist | 1210 Ward Ave, Caruthersville, MO 63830 | 2006-11-09 |
| 1366512287 | Krilurk Chanvitayapongs | Pharmacist | 2709 South Ward, Caruthersville, MO 63830 | 2006-11-08 |
| Find all providers in zip 63830 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457708018 | Caruthersville No 1 Inc | Skilled Nursing Facility | 500 Truman Blvd, Caruthersville, MO 63830-1261 | 2016-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609492719 | Ignite Medical Resort Independence LLC | Skilled Nursing Facility | 20511 E. Trinity Pl., Blue Springs, MO 64015 | 2020-06-24 |
| 1760006308 | Sunterra Dardenne Prairie Oc LLC | Skilled Nursing Facility | 7275 Highway N, Dardenne Prairie, MO 63368-7126 | 2020-05-29 |
| 1184247215 | Berry Medical Properties, LLC | Skilled Nursing Facility | 11380 Natural Bridge Rd, Bridgeton, MO 63044-2307 | 2020-05-23 |
| 1881249464 | Rolla Grand LLC | Skilled Nursing Facility | 1800 White Columns Dr, Rolla, MO 65401-2044 | 2019-08-09 |
| 1184276982 | Willow Health Care Inc | Skilled Nursing Facility | 712 Copper Rock Dr, Rogersville, MO 65742-8970 | 2019-07-11 |
| 1548734627 | Medicore Medical Service LLC | Skilled Nursing Facility | 2303 Kratky Rd Apt B, Saint Louis, MO 63114-1783 | 2019-01-11 |
| 1518436724 | Missouri Nursing & Rehab LLC | Skilled Nursing Facility | 783 Weber Road, Farmington, MO 63640-3318 | 2018-11-16 |
| 1982172342 | Arrowhead Retirement Operations LLC | Skilled Nursing Facility | 6100 Arrowhead Drive, Osage Beach, MO 65065 | 2018-11-05 |
| 1578039467 | Laverna Senior Living LLC | Skilled Nursing Facility | 904 S Hall Ave, Savannah, MO 64485-1952 | 2018-10-17 |
| 1093297152 | Community Care Center of Union Inc | Skilled Nursing Facility | 1080 Marie Lane, Union, MO 63084 | 2018-09-05 |
| Find all providers with the same taxonomy | ||||
| City | CARUTHERSVILLE |
| Zip Code | 63830 |
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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.