PEMISCOT COUNTY MEMORIAL HOSPITAL (NPI# 1861594004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861594004 |
| Entity Type | Organization |
| Organization Name | PEMISCOT COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | PEMISCOT COUNTY NURSING HOME |
| Practice Address |
946 E Reed St Hayti MO 63851-1243 |
| Mailing Address |
946 E Reed St P O Box 489 Hayti MO 63851-1243 |
| Practice Telephone | 5733593612 |
| Practice Fax Number | 5733593398 |
| Mailing Telephone | 5733593612 |
| Mailing Fax Number | 5733593398 |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2011-11-02 |
| Authorized Official Name | KERRY NOBLE (CEO) |
| Authorized Official Telephone | 5733593612 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | MO | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 101493104 | 05 |
| Other Name | Type Code |
|---|---|
| Pemiscot County Nursing Home | 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 |
| 1669493144 | Pemiscot County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 500 Truman Blvd, Caruthersville, MO 63830-1261 | 2006-07-21 |
| 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 |
| Street Address |
946 E REED ST |
| City | HAYTI |
| State | MO |
| Zip Code | 63851-1243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013987510 | Lara Huffman | Psychiatry & Neurology | 946 E Reed St, Hayti, MO 63851-1243 | 2006-01-25 |
| 1144887001 | Faaiza Arshad | Physician Assistant | 946 E Reed St, Hayti, MO 63851-1243 | 2019-05-24 |
| 1114379153 | Pemiscot Memorial Health System | General Acute Care Hospital | 946 E Reed St, Hayti, MO 63851-1243 | 2016-07-01 |
| 1386095339 | Linda Tai | Physician Assistant | 946 E Reed St, Hayti, MO 63851-1243 | 2016-06-30 |
| 1497069199 | Pafford Emergency Medical Services of Missouri, Inc. | Ambulance | 946 E Reed St, Hayti, MO 63851-1243 | 2010-08-05 |
| 1710159314 | Pemiscot County Memorial Hospital | Psychiatric Unit | 946 E Reed St, Hayti, MO 63851-1243 | 2008-03-24 |
| 1265602544 | David Ketchum II | Pharmacist | 946 E Reed St, Hayti, MO 63851-1243 | 2008-03-03 |
| 1033393335 | Hazel Radiology, LLC | Radiology | 946 E Reed St, Radiology Department, Hayti, MO 63851-1243 | 2007-12-21 |
| 1578668661 | Pemiscot County Memorial Hospital | Clinic/Center | 946 E Reed St, Hayti, MO 63851-1243 | 2006-09-13 |
| 1437251881 | Pemiscot County Memorial Hospital | General Acute Care Hospital | 946 E Reed St, Hayti, MO 63851-1243 | 2006-09-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619518032 | Mcpherson Medical & Diagnostic, LLC | Clinic/Center | 110 Us Hwy 61 N, Ste B, Hayti, MO 63851 | 2019-10-07 |
| 1225525744 | Roosevelt Dismukes Jr. | Behavior Technician | 500 Highway 61 N J, Hayti, MO 63851 | 2018-04-19 |
| 1417461625 | Rivian Ricole Hill | Recreation Therapist | 501 Highway 61 J N, Hayti, MO 63851 | 2017-11-27 |
| 1750761169 | Lindsey Moody | Case Manager/Care Coordinator | 909 East Reed Street, Hayti, MO 63851 | 2015-06-02 |
| 1710375811 | Jeremy Winstead | Technician, Other | 500 Highway J North, Hayti, MO 63851 | 2014-12-26 |
| 1164810206 | Teresa Ward | Registered Nurse | 589 Hwy J, Hayti, MO 63851 | 2014-12-23 |
| 1780081463 | Heather Brown | Case Manager/Care Coordinator | 581 Hwy J, Hayti, MO 63851 | 2014-11-25 |
| 1184029241 | Cheryl Byrd | Case Manager/Care Coordinator | 581 Highway J, Hayti, MO 63851 | 2014-10-30 |
| 1114320827 | Toshia Russell | Licensed Practical Nurse | 579 North Highway J, Hayti, MO 63851 | 2014-10-08 |
| 1992104301 | Lora Hawes | Case Manager/Care Coordinator | 581 Hwy J North, Hayti, MO 63851 | 2014-08-21 |
| Find all providers in zip 63851 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508078254 | Pemiscot County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 946 E Reed Street, Hayti, MO 63851-0489 | 2007-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316488075 | Anna's House Residential Care Facility LLC | Nursing Facility/Intermediate Care Facility | 194 State Highway Mm, Niangua, MO 65713-8411 | 2017-03-14 |
| 1841667565 | Univest, LLC | Nursing Facility/Intermediate Care Facility | 1401 W 3rd St, Sedalia, MO 65301-3603 | 2015-08-28 |
| 1417334137 | Holistic Healthcare LLC | Nursing Facility/Intermediate Care Facility | 4630 Robbins Grove Dr, Florissant, MO 63034-2840 | 2015-05-01 |
| 1295123420 | Erin Eggen | Nursing Facility/Intermediate Care Facility | 1101 Clay Street, Versailles, MO 65084 | 2014-12-22 |
| 1518303296 | Leaetta Mildred Gardner | Nursing Facility/Intermediate Care Facility | 13450 County Road 7040, Rolla, MO 65401 | 2013-05-21 |
| 1376893297 | Reliant Care Rehabilitative Services | Nursing Facility/Intermediate Care Facility | 411 Robert Ave, Ferguson, MO 63135-3526 | 2012-09-18 |
| 1487975363 | Neighborhood Outreach Center | Nursing Facility/Intermediate Care Facility | 5325 Dr Martin Luther King Dr, Saint Louis, MO 63112-4256 | 2010-06-15 |
| 1205168523 | Nirmal K Samanta | Nursing Facility/Intermediate Care Facility | 250 Brandy Ln, Cape Girardeau, MO 63701-8443 | 2010-02-11 |
| 1083882682 | Crestwood Health Care Center, L.L.C. | Nursing Facility/Intermediate Care Facility | 11400 Mehl Avenue, Florissant, MO 63033-7204 | 2008-02-15 |
| 1225228455 | St Josephs Hill Infirmary Inc | Nursing Facility/Intermediate Care Facility | 265 St Joseph Road, Eureka, MO 63025-0550 | 2007-07-25 |
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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.