COOPER COUNTY MEMORIAL HOSPITAL (NPI# 1871626234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871626234 |
| Entity Type | Organization |
| Organization Name | COOPER COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | CCMH FAMILY HEALTH CLINIC |
| Practice Address |
600 W Morrison St Suite 5 Fayette MO 65248-1075 |
| Mailing Address |
17651 B Hwy Boonville MO 65233-2839 |
| Practice Telephone | 6602482900 |
| Practice Fax Number | 6602481544 |
| Mailing Telephone | 6608827461 |
| Mailing Fax Number | 6608824136 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2014-07-25 |
| Authorized Official Name | DANIELLE GEARHART (ADMIN CEO) |
| Authorized Official Telephone | 6608827461 |
| 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 | 590328506 | 05 | |
| MO | MEDICARE ID/OSCAR | 26-3483 | 01 |
| Other Name | Type Code |
|---|---|
| CCMH Family Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811332935 | Cooper County Memorial Hospital | Clinic/Center | 108 Market St, Glasgow, MO 65254-1053 | 2013-05-02 |
| 1487807657 | Cooper County Memorial Hospital | General Acute Care Hospital | 17651 B Hwy, Boonville, MO 65233-2839 | 2008-10-31 |
| 1306066162 | Cooper County Memorial Hospital | Skilled Nursing Facility | 17651 B Hwy, Boonville, MO 65233-2839 | 2007-04-26 |
| Street Address |
600 W MORRISON ST SUITE 5 |
| City | FAYETTE |
| State | MO |
| Zip Code | 65248-1075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346242484 | Howard County Commission | Public Health or Welfare | 600 W Morrison St, Ste 7, Fayette, MO 65248-1075 | 2005-06-01 |
| 1114579026 | Crossroads Counseling | Counselor | 600 W Morrison St, Fayette, MO 65248-1471 | 2019-07-10 |
| 1700125382 | Jessica Michelle Beasley | Counselor | 600 W Morrison St, Ste 18, Fayette, MO 65248-1075 | 2013-02-02 |
| 1376840090 | Nathan Reed Hepner | Counselor | 600 W Morrison St, Suite 18, Fayette, MO 65248-1075 | 2011-02-15 |
| 1477855336 | Solcollin Aliscia Heard | Counselor | 600 W Morrison St, Ste. 18, Fayette, MO 65248-1075 | 2010-11-29 |
| 1992006399 | Leann Elizabeth Williams | Nurse Practitioner | 600 W Morrison St, Suite 5, Fayette, MO 65248-1075 | 2010-11-16 |
| 1699957597 | Felicia Ekwutosi Anunoby | Nurse Practitioner | 600 W Morrison St, Suite 5, Fayette, MO 65248-1075 | 2007-12-03 |
| 1316140494 | John Fitzgibbon Memorial Hospital, Inc. | Clinic/Center | 600 W Morrison St, Suite 5, Fayette, MO 65248-1075 | 2007-06-07 |
| 1578688412 | Terrence F Flanagan | Nurse Practitioner | 600 W Morrison St, Suite 5, Fayette, MO 65248-1075 | 2007-03-20 |
| 1679697346 | Kerry A Kroeker | Specialist | 600 W Morrison St, Suite 5, Fayette, MO 65248-1075 | 2007-03-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871658799 | Health Care Consultants of Mid Missouri, Inc. | Assisted Living Facility | 420 County Road 112, Fayette, MO 65248 | 2006-12-22 |
| 1932643160 | Brandon Michael Wiler | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248 | 2016-12-07 |
| 1326075391 | Robert Neal Buffaloe | Family Medicine | 308 S Church St, Fayette, MO 65248 | 2006-06-27 |
| 1740376219 | Howard County Home Health and Hospice | Hospice Care, Community Based | 101 Furr St, Fayette, MO 65248-1069 | 2006-10-04 |
| 1861496531 | Howard County Home Health and Hospice | Home Health | 101 Furr Street, Fayette, MO 65248-1069 | 2005-06-09 |
| 1013342955 | Howard County Home Health and Hospice | In Home Supportive Care | 101 Furr St, Fayette, MO 65248-1069 | 2013-09-11 |
| 1003815333 | Howard County Ambulance District | Ambulance | 100 S Williams St, Fayette, MO 65248-1086 | 2005-07-19 |
| 1952399776 | Rick Errett Sage | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2005-10-06 |
| 1346734423 | Kimberly Mikulan | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2018-06-21 |
| 1013429851 | Kelsey Nicole Stuenkel | Specialist/Technologist | 411 Central Methodist Sq, Fayette, MO 65248-1104 | 2017-11-02 |
| Find all providers in zip 65248 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194365338 | Bounds Family Medical | Clinic/Center | 870 Main St Ste A, Fayette, MS 39069-5695 | 2020-01-15 |
| 1053366518 | Gundersen Clinic, Ltd. | Clinic/Center | 110 King Street, Fayette, IA 52142 | 2006-05-23 |
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|---|---|---|---|---|
| 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 |
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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.