JOHN FITZGIBBON MEMORIAL HOSPITAL, INC. (NPI# 1922032549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922032549 |
| Entity Type | Organization |
| Organization Name | JOHN FITZGIBBON MEMORIAL HOSPITAL, INC. |
| Other Organization Name | GRAND RIVER MEDICAL CENTER |
| Practice Address |
815 E. Broadway Street Brunswick MO 65236-1468 |
| Mailing Address |
2305 South 65 Highway Marshall MO 65340-3702 |
| Practice Telephone | 6608867431 |
| Practice Fax Number | 6608313328 |
| Mailing Telephone | 6605483161 |
| Mailing Fax Number | 6605843096 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2016-01-14 |
| Authorized Official Name | DARIN HAUG (PRESIDENT & CEO) |
| Authorized Official Telephone | 6608867431 |
| Is Organization Subpart | Y |
| Parent Organization Name | JOHN FITZGIBBON MEMORIAL HOSPITAL, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
598917607 | MO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 598917607 | 05 | |
| MO | 508292604 | 05 |
| Other Name | Type Code |
|---|---|
| Grand River Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780131771 | John Fitzgibbon Memorial Hospital, Inc. | Chiropractor | 2305 South 65 Highway Building A, Marshall, MO 65340-3702 | 2016-09-07 |
| 1134752140 | John Fitzgibbon Memorial Hospital, Inc. | Clinic/Center | 4 N Jefferson Ave, Marshall, MO 65340-2148 | 2020-02-18 |
| 1780077065 | John Fitzgibbon Memorial Hospital, Inc. | Clinic/Center | 2305 South 65 Highway, Marshall, MO 65340-3702 | 2015-03-11 |
| 1073748786 | John Fitzgibbon Memorial Hospital, Inc. | Registered Nurse | 2305 South 65 Highway, Marshall, MO 65340-3702 | 2009-05-26 |
| 1831351345 | John Fitzgibbon Memorial Hospital, Inc. | Medicare Defined Swing Bed Unit | 2305 South 65 Highway, Marshall, MO 65340-3702 | 2008-06-26 |
| 1316140494 | John Fitzgibbon Memorial Hospital, Inc. | Clinic/Center | 600 W Morrison St, Suite 5, Fayette, MO 65248-1075 | 2007-06-07 |
| 1215059985 | John Fitzgibbon Memorial Hospital, Inc. | Clinic/Center | 2305 S Highway 65, Marshall, MO 65340-3702 | 2007-04-04 |
| 1285779330 | John Fitzgibbon Memorial Hospital, Inc. | Psychiatry & Neurology | 2305 South 65 Highway, Building A, Marshall, MO 65340-3702 | 2007-02-20 |
| 1942220751 | John Fitzgibbon Memorial Hospital, Inc. | Hospice Care, Community Based | 2305 South 65 Highway, Marshall, MO 65340-3702 | 2006-07-21 |
| 1558388173 | John Fitzgibbon Memorial Hospital, Inc. | Clinic/Center | 2305 S 65 Highway, Marshall, MO 65340-3702 | 2006-07-17 |
| Street Address |
815 E. BROADWAY STREET |
| City | BRUNSWICK |
| State | MO |
| Zip Code | 65236-1468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518075316 | Jessica L Elliott | Speech-Language Pathologist | 107 E Harrison St, Brunswick, MO 65236 | 2006-08-29 |
| 1265422331 | Lightning Creek Investment Group,inc | Skilled Nursing Facility | 721 W Harrison St, Brunswick, MO 65236 | 2005-10-28 |
| 1093295354 | Paige Mchugh | Physical Therapy Assistant | 406 Keyte St, Brunswick, MO 65236-1036 | 2018-08-16 |
| 1700422482 | Ashley Simpson | Occupational Therapy Assistant | 721 W Harrison St, Brunswick, MO 65236-1096 | 2019-11-18 |
| 1518503200 | Margaret J Larson | Speech-Language Pathologist | 721 W Harrison St, Brunswick, MO 65236-1096 | 2019-11-18 |
| 1922540848 | Jukeco Enterprises LLC | Skilled Nursing Facility | 721 W Harrison St, Brunswick, MO 65236-1096 | 2016-11-09 |
| 1205013224 | Danielle Elizabeth Hamilton | Physical Therapy Assistant | 721 W Harrison St, Brunswick, MO 65236-1096 | 2008-01-22 |
| 1417011313 | Joanie M Defibaugh | Social Worker | 107 E Harrison St, Brunswick, MO 65236-1267 | 2006-12-22 |
| 1366581951 | Brunswick R-ii Schools | Physical Therapist | 1008 County Rd, Brunswick, MO 65236-1445 | 2007-02-06 |
| 1619200565 | Nancy J Lock | Physical Therapist | 1008 County Rd, Brunswick, MO 65236-1445 | 2009-09-10 |
| Find all providers in zip 65236 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 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 | ||||
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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.