CITIZENS MEMORIAL HOSPITAL DISTRICT (NPI# 1003945213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003945213 |
| Entity Type | Organization |
| Organization Name | CITIZENS MEMORIAL HOSPITAL DISTRICT |
| Practice Address |
1500 N Oakland Ave Bolivar MO 65613-3011 |
| Practice Telephone | 4173266000 |
| Mailing Telephone | 4173266000 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2008-05-14 |
| Authorized Official Name | MR. DONALD J BABB (CEO) |
| Authorized Official Telephone | 4173286401 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 313-24 | MO | Hospital Units |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053712109 | Citizens Memorial Hospital District | Pharmacy | 1301-b North Oakland, Bolivar, MO 65613 | 2014-09-09 |
| 1619303823 | Citizens Memorial Hospital District | Durable Medical Equipment & Medical Supplies | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2013-09-19 |
| 1932545043 | Citizens Memorial Hospital District | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2013-05-15 |
| 1154598795 | Citizens Memorial Hospital District | Durable Medical Equipment & Medical Supplies | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2008-05-13 |
| 1558548818 | Citizens Memorial Hospital District | Anesthesiology | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2008-01-29 |
| 1841328424 | Citizens Memorial Hospital District | Medicare Defined Swing Bed Unit | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2007-03-02 |
| 1003981549 | Citizens Memorial Hospital District | General Acute Care Hospital | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2006-11-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CITIZENS MEMORIAL HOSPITAL DISTRICT OF POLK COUNTY | 1500 N Oakland Ave, Bolivar, MO 65613-3011 |
| Street Address |
1500 N OAKLAND AVE |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613-3011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992705305 | Bryan E Flueckiger | Psychiatry & Neurology | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2005-07-28 |
| 1750994281 | Lynetta S Smith | Dietitian, Registered | 1500 N Oakland Ave, Bolivar, MO 65613-3099 | 2020-08-25 |
| 1689282485 | Austin Gott | Dietitian, Registered | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2020-07-17 |
| 1275141129 | Mesha Cowan | Dietitian, Registered | 1500 N Oakland Ave, Bolivar, MO 65613-3099 | 2020-07-16 |
| 1700427358 | Micah Miller | Physician Assistant | 1500 N Oakland Ave, Bolivar, MO 65613-3099 | 2019-10-04 |
| 1619438009 | Kristina Vance | Occupational Therapist | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2019-03-27 |
| 1417420381 | Melissa Sue Moores | Social Worker | 1500 N Oakland Ave, Bolivar, MO 65613-3099 | 2019-01-03 |
| 1982171625 | Kimberly Doolin | Registered Nurse | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2018-10-31 |
| 1356837694 | Katelynn Stewart | Specialist/Technologist | 1500 N Oakland Ave, Bolivar, MO 65613-3099 | 2018-07-10 |
| 1902315401 | Daniel J Ferguson | Nurse Practitioner | 1500 N Oakland Ave, Bolivar, MO 65613-3011 | 2017-09-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301552 | Casablanca Care Center, LLC | Home Health | 524 S. Albany Avenue, Bolivar, MO 65613 | 2020-09-18 |
| 1669087045 | Revive Medical LLC | Durable Medical Equipment & Medical Supplies | 5000, S Scenic, Bolivar, MO 65613 | 2020-09-11 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1932754744 | Caitlin M Williams | Specialist/Technologist | 1260 S Pike Avenue, Bolivar, MO 65613 | 2019-08-08 |
| 1073022406 | Jacquelyn Rose Kemnic | Dietitian, Registered | Heart Center, 1500 N Oakland Ave, Willard, MO 65613 | 2017-09-28 |
| 1164897161 | Ozarks Resource Group | Clinic/Center | 203 E. Broadway St., Bolivar, MO 65613 | 2015-12-02 |
| 1962895292 | Professional Christian Counseling | Counselor | 4888 S 139th Road, Bolivar, MO 65613 | 2015-03-11 |
| 1073916573 | Scott Leslie Dennis | Physician Assistant | 1500 North Oakland Ave, Citizens Memorial Hospital, Bolivar, MO 65613 | 2014-09-29 |
| 1053712109 | Citizens Memorial Hospital District | Pharmacy | 1301-b North Oakland, Bolivar, MO 65613 | 2014-09-09 |
| 1740680453 | Jamee M Stimpson | Occupational Therapist | 454 S. Main Avenue, Bolivar, MO 65613 | 2014-08-29 |
| Find all providers in zip 65613 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033499256 | University of Missori Health System | Psychiatric Unit | Dept of Medicine Univ of Missouri, One Hospital Drive Ne402, Columbia, MO 65212-0001 | 2011-08-18 |
| 1629391636 | Farmington Missouri Hospital Company, LLC | Psychiatric Unit | 1212 Weber St., Farmington, MO 63640-3325 | 2010-03-04 |
| 1346312873 | Phelps County Regional Medical Center | Psychiatric Unit | 1000 West 1oth Street, Rolla, MO 65401 | 2006-11-13 |
| 1700831724 | Poplar Bluff Regional Medical Center LLC | Psychiatric Unit | 3100 Oak Grove Rd., Poplar Bluff, MO 63901 | 2006-05-24 |
| 1912989351 | Cass Medical Center | Psychiatric Unit | 1800 E Mechanic St, Harrisonville, MO 64701-2017 | 2005-11-18 |
| 1124012356 | Columbia Regional Hospital - Psychiatric Unit | Psychiatric Unit | 404 Keene St, Columbia, MO 65201-6626 | 2005-09-02 |
| 1023017746 | St Alexius Hospital Corporation 1 | Psychiatric Unit | 3933 S Broadway, Saint Louis, MO 63118-4601 | 2005-07-14 |
| 1427661792 | Noble Health Fulton Inc. | Psychiatric Unit | 10 S Hospital Dr, Fulton, MO 65251-2510 | 2020-08-26 |
| 1477027803 | Mosaic Medical Center - Maryville | Psychiatric Unit | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
| 1376031757 | Prime Healthcare Services - Kansas City LLC | Psychiatric Unit | 1000 Carondelet Dr, Kansas City, MO 64114-4673 | 2018-05-01 |
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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.