PEMISCOT COUNTY MEMORIAL HOSPITAL (NPI# 1932372646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932372646 |
| Entity Type | Organization |
| Organization Name | PEMISCOT COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | BOOTHEEL PRIMARY CARE NEW MADRID |
| Practice Address |
555 Virginia Ave New Madrid MO 63869 |
| Mailing Address |
Po Box 442 Hayti MO 63851-0442 |
| Practice Telephone | 5737483107 |
| Practice Fax Number | 5737483112 |
| Mailing Telephone | 5733593659 |
| Mailing Fax Number | 5733593608 |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2018-06-22 |
| Authorized Official Name | CATHY LACEY (CREDENTIALING DIRECTOR) |
| Authorized Official Telephone | 5733593659 |
| Is Organization Subpart | Y |
| Parent Organization Name | PEMISCOT COUNTY MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
MO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 597723402 | 05 |
| Other Name | Type Code |
|---|---|
| Bootheel Primary Care New Madrid | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 310 E Main St, Hayti, MO 638511639 | 5733592019 |
| 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 |
| 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 |
| 1710159314 | Pemiscot County Memorial Hospital | Psychiatric Unit | 946 E Reed St, Hayti, MO 63851-1243 | 2008-03-24 |
| Street Address |
555 VIRGINIA AVE |
| City | NEW MADRID |
| State | MO |
| Zip Code | 63869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558924845 | Sierra Elaine Holiman | Nurse Practitioner | 800 Us Hwy 61, New Madrid, MO 63869 | 2019-04-22 |
| 1083143325 | Family Matters Home Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 985 Ramsey Lane, New Madrid, MO 63869 | 2017-06-09 |
| 1174849491 | Lorenzo Antonio Aquino Tolentino | Physical Therapist | 1050 Dawson Road, New Madrid, MO 63869 | 2010-04-12 |
| 1043467285 | Betty Ann Cagle | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 131 St. Thomas Lane, New Madrid, MO 63869 | 2008-08-19 |
| 1629138425 | Timothy P Rausch | Dentist | 645 Us Hwy 61, New Madrid, MO 63869 | 2006-12-11 |
| 1821628850 | Family Matters In Home LLC | In Home Supportive Care | 415 Main St, New Madrid, MO 63869 | 2020-01-17 |
| 1508314907 | Family Matters Cds LLC | Home Health | 413 Main Street, New Madrid, MO 63869 | 2016-09-14 |
| 1649657495 | Trusted Hands Direct LLC | In Home Supportive Care | 1 Courthouse Square, New Madrid, MO 63869 | 2015-04-30 |
| 1598161739 | Trusted Hands In Home Supportive Services | In Home Supportive Care | 1 Courthouse Square, New Madrid, MO 63869 | 2014-11-17 |
| 1518304369 | Southeast Missouri Health Network | Clinical Medical Laboratory | 421 Line Street, New Madrid, MO 63869 | 2013-06-03 |
| Find all providers in zip 63869 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639736457 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 800 Us Highway 61, New Madrid, MO 63869-1106 | 2019-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 |
| 1831515907 | Marble Hill Medical Clinic, LLC | Clinic/Center | 307 Broadway St., Marble Hill, MO 63764-8321 | 2014-03-12 |
| Find all providers with the same taxonomy | ||||
| City | NEW MADRID |
| Zip Code | 63869 |
Please comment or provide details below to improve the information on PEMISCOT COUNTY MEMORIAL HOSPITAL.
| 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.