MADISON MEDICAL CENTER STOCKHOFF MEMORIAL NURSING HOME (NPI# 1720163025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720163025 |
| Entity Type | Organization |
| Organization Name | MADISON MEDICAL CENTER STOCKHOFF MEMORIAL NURSING HOME |
| Other Organization Name | MADISON MEMORIAL HOSPITAL |
| Practice Address |
611 W Main St Fredericktown MO 63645-1111 |
| Mailing Address |
611 W Main St Po Box 431 Fredericktown MO 63645-1111 |
| Practice Telephone | 5737833341 |
| Practice Fax Number | 5737831096 |
| Mailing Telephone | 5737833341 |
| Mailing Fax Number | 5737831096 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2008-06-25 |
| Authorized Official Name | MS. LISA MARIE TWIDWELL (CFO) |
| Authorized Official Telephone | 5737833341 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
209-45 | MO | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 010155109 | 05 |
| Other Name | Type Code |
|---|---|
| MADISON MEMORIAL HOSPITAL | Former Legal Business Name - 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 |
| 1467539031 | Madison Medical Center Stockhoff Memorial Nursing Home | Clinic/Center | 611 West Main Street, Fredericktown, MO 63645 | 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 |
| Street Address |
611 W MAIN ST |
| City | FREDERICKTOWN |
| State | MO |
| Zip Code | 63645-1111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548235419 | Ashvin D. Patel | Emergency Medicine | 611 W Main St, Fredericktown, MO 63645-1111 | 2006-02-22 |
| 1306402680 | Alanna Guess | Nurse Practitioner | 611 W Main St, Fredericktown, MO 63645-1111 | 2019-05-13 |
| 1225487143 | Heather Cheaney | Clinical Nurse Specialist | 611 W Main St, Fredericktown, MO 63645-1111 | 2016-06-10 |
| 1225355027 | Craig J. Millham | Mechanotherapist | 611 W Main St, Fredericktown, MO 63645-1111 | 2010-05-03 |
| 1154648954 | Michele Rubel | Mechanotherapist | 611 W Main St, Fredericktown, MO 63645-1111 | 2010-05-03 |
| 1760630032 | Madison County Ambulance District | Ambulance | 611 W Main St, Fredericktown, MO 63645-1111 | 2008-08-28 |
| 1558545871 | Corinna D Defrancesco | Nurse Practitioner | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-12-21 |
| 1780802512 | Susan Lee Krydynski | Occupational Therapist | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-04-24 |
| 1669514436 | Madison Medical Center | Emergency Medicine | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-02-12 |
| 1801948880 | Madison Medical Center | Pharmacy | 611 W Main St, Fredericktown, MO 63645-1111 | 2007-01-18 |
| Find all providers in the same location | ||||
| 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 |
| 1467539031 | Madison Medical Center Stockhoff Memorial Nursing Home | Clinic/Center | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-01 |
| 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 |
| 1235392309 | Humberto Jose Olivero Lara | Family Medicine | 611 West Main Street, Fredericktown, MO 63645 | 2008-07-08 |
| 1003983859 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Pharmacy | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-29 |
| Find all providers in zip 63645 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356689905 | Southeast Health Center of Reynolds County LLC | General Acute Care Hospital | 100 Hwy 21, Ellington, MO 63638-7943 | 2013-01-16 |
| 1467789222 | Va Medical Center In St.louis | General Acute Care Hospital | 9830 Eastdell Dr, Saint Louis, MO 63136-1915 | 2009-11-14 |
| 1750512042 | Vicky Laurine Simbro | General Acute Care Hospital | 4505 Cove Rd, Osage Beach, MO 65065-2307 | 2009-08-04 |
| 1710177480 | Wisam Hassan Ali Al Badr | General Acute Care Hospital | 3635 Grand Blvd, Saint Louis, MO 63110-2539 | 2007-07-30 |
| 1619179561 | Saint Louis University Medical Center | General Acute Care Hospital | 1402 S Grand Blvd # M238, Saint Louis, MO 63104-1004 | 2007-06-04 |
| 1962578609 | Hermann Area Hospital District | General Acute Care Hospital | 509 West 18th St, Hermann, MO 65041 | 2006-11-27 |
| 1477648178 | Iron County Hospital District | General Acute Care Hospital | 301 N Highway 21, Pilot Knob, MO 63663-0548 | 2006-10-04 |
| 1023053477 | Mercy St. Francis Hospital | General Acute Care Hospital | 100 West Highway 60, Mountain View, MO 65548 | 2006-06-19 |
| 1912948308 | Saint Lukes Hospital of Chillicothe | General Acute Care Hospital | 2799 N Washington, Chillicothe, MO 64601-2902 | 2006-06-09 |
| 1720039605 | Cedar County Memorial Hospital | General Acute Care Hospital | 1401 S Park St, El Dorado Springs, MO 64744-2037 | 2006-05-15 |
| 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.