PEMISCOT COUNTY MEMORIAL HOSPITAL (NPI# 1992807390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992807390 |
| Entity Type | Organization |
| Organization Name | PEMISCOT COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | BOOTHEEL PRIMARY CARE CLINIC - KENNETT |
| Practice Address |
304 Teaco Rd Kennett MO 63857 |
| Mailing Address |
Po Box 442 Hayti MO 63851-0442 |
| Practice Telephone | 5738888828 |
| Practice Fax Number | 5738888830 |
| Mailing Telephone | 5733593659 |
| Mailing Fax Number | 5733593608 |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2018-07-06 |
| Authorized Official Name | LEIGHA WARD (CFO) |
| Authorized Official Telephone | 5733593612 |
| 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 | 598517803 | 05 |
| Other Name | Type Code |
|---|---|
| Bootheel Primary Care Clinic - Kennett | 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 |
304 TEACO RD |
| City | KENNETT |
| State | MO |
| Zip Code | 63857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922070903 | Massey Family Care LLC | Family Medicine | 304 Teaco Rd, Ste B, Kennett, MO 63857 | 2006-02-03 |
| 1043485873 | Massey Family Care | Family Medicine | 304 Teaco Rd, Suite B, Kennett, MO 63857-3266 | 2008-04-23 |
| 1841465689 | Willow Family Care | Family Medicine | 304 Teaco Rd, Suite A, Kennett, MO 63857-3266 | 2008-04-23 |
| 1720272834 | Willow Family Medicine, LLC | Family Medicine | 304 Teaco Rd, Suite A, Kennett, MO 63857-3266 | 2007-08-31 |
| 1043363005 | Nelson R Perez | Obstetrics & Gynecology | 304 Teaco Rd, Suite G, Kennett, MO 63857-3266 | 2007-01-20 |
| 1043363013 | Healthcare for Women, Inc. | Clinic/Center | 304 Teaco Rd, Suite G, Kennett, MO 63857-3266 | 2007-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992278139 | Fancilla Adams | Counselor | 925 State Highway V V, Kennett, MO 63857 | 2019-01-10 |
| 1962994418 | Kiana Alexis Brown | Behavior Technician | 925 Highway W, Kennett, MO 63857 | 2018-05-31 |
| 1568953636 | Doctors Health Group, Inc | Family Medicine | 1312 First Street, Kennett, MO 63857 | 2018-05-24 |
| 1003328873 | Ann Graf | Counselor | 925 Vv, Kennett, MO 63857 | 2017-11-01 |
| 1457872160 | Jessica Luster | Technician, Other | 1109 Jones St., Kennett, MO 63857 | 2017-07-03 |
| 1235669128 | Chandra Celeste Perkins-shannon | Case Manager/Care Coordinator | 925 Hwy V, Kennett, MO 63857 | 2017-06-14 |
| 1467991612 | Sarah Lobdell | Case Manager/Care Coordinator | 925 State Highway Vv, Kennett, MO 63857 | 2017-02-21 |
| 1881132900 | Brandy Rios | Community Health Worker | 935 State Hwy Vv, Kennett, MO 63857 | 2017-02-09 |
| 1295272060 | Johnny Marie Johnson | Case Manager/Care Coordinator | 925 Hwy Vv Family Counseling Center, Kennett, MO 63857 | 2017-01-31 |
| 1043756364 | Heather Bowman | Case Manager/Care Coordinator | 875 Hwy Vv, Kennett, MO 63857 | 2017-01-10 |
| Find all providers in zip 63857 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205387024 | Kennett Hma LLC | Clinic/Center | 1231 1st St, Kennett, MO 63857-2527 | 2016-10-17 |
| 1477821684 | Kennett Hma LLC | Clinic/Center | 1231 1st St, Suite 5, Kennett, MO 63857-2527 | 2011-12-02 |
| 1023342987 | Kennett Hma LLC | Clinic/Center | 509 South Byp, Kennett, MO 63857-3248 | 2009-09-25 |
| 1811166465 | Amy R Lockhert | Clinic/Center | 105 E Washington St, Kennett, MO 63857-2041 | 2008-02-28 |
| 1043363013 | Healthcare for Women, Inc. | Clinic/Center | 304 Teaco Rd, Suite G, Kennett, MO 63857-3266 | 2007-01-20 |
| 1245271915 | Kennett Hma Inc | Clinic/Center | 1301 1st St, Kennett, MO 63857-2525 | 2006-06-10 |
| 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 |
| 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 |
| 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.