SULLIVAN COUNTY MEMORIAL HOSPITAL (NPI# 1063553642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063553642 |
| Entity Type | Organization |
| Organization Name | SULLIVAN COUNTY MEMORIAL HOSPITAL |
| Practice Address |
630 W 3rd St Milan MO 63556-1076 |
| Practice Telephone | 6602654212 |
| Practice Fax Number | 6602654898 |
| Mailing Telephone | 6602654212 |
| Mailing Fax Number | 6602654898 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2011-05-16 |
| Authorized Official Name | AMY MICHAEL (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6602654212 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 130-49 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 540324803 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770624967 | Sullivan County Memorial Hospital | Clinic/Center | 106 North Main, Newtown, MO 64667-1000 | 2007-02-09 |
| 1518008218 | Sullivan County Memorial Hospital | Clinic/Center | 18 W 3rd St, Green City, MO 63545-1361 | 2007-02-08 |
| 1619065828 | Sullivan County Memorial Hospital | Clinic/Center | 210 N Market St, Milan, MO 63556-1316 | 2006-10-11 |
| 1275674699 | Sullivan County Memorial Hospital | General Acute Care Hospital | 630 W 3rd St, Milan, MO 63556-1076 | 2007-02-09 |
| 1285775858 | Sullivan County Memorial Hospital | Clinic/Center | 630 W 3rd St, Milan, MO 63556 | 2007-02-08 |
| 1114067832 | Sullivan County Memorial Hospital | General Acute Care Hospital | 630 W 3rd St, Milan, MO 63556-1076 | 2007-02-08 |
| 1598806168 | Sullivan County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 630 W 3rd St, Milan, MO 63556-1076 | 2007-02-08 |
| Street Address |
630 W 3RD ST |
| City | MILAN |
| State | MO |
| Zip Code | 63556-1076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659479061 | Thomas Edwin Williams | Family Medicine | 630 W 3rd St, Milan, MO 63556-1076 | 2006-09-20 |
| 1487005435 | Michelle Lynn Greathouse | Nurse Practitioner | 630 W 3rd St, Milan, MO 63556-1076 | 2016-06-30 |
| 1528324779 | Ryan Williams | Family Medicine | 630 W 3rd St, Milan, MO 63556-1076 | 2012-04-02 |
| 1780843623 | Martha Kay Curtis | Nurse Practitioner | 630 W 3rd St, Milan, MO 63556-1076 | 2008-06-05 |
| 1023159514 | Vivian Marlene Hall | Nurse Practitioner | 630 W 3rd St, Milan, MO 63556-1076 | 2007-02-09 |
| 1275674699 | Sullivan County Memorial Hospital | General Acute Care Hospital | 630 W 3rd St, Milan, MO 63556-1076 | 2007-02-09 |
| 1285775858 | Sullivan County Memorial Hospital | Clinic/Center | 630 W 3rd St, Milan, MO 63556 | 2007-02-08 |
| 1114067832 | Sullivan County Memorial Hospital | General Acute Care Hospital | 630 W 3rd St, Milan, MO 63556-1076 | 2007-02-08 |
| 1598806168 | Sullivan County Memorial Hospital | Nursing Facility/Intermediate Care Facility | 630 W 3rd St, Milan, MO 63556-1076 | 2007-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366786246 | Rolling Hills Residential Care Facility, LLC | Assisted Living Facility | 24583 Hwy 5, Milan, MO 63556 | 2012-11-16 |
| 1326160821 | High Hope Employment Services, Inc. | Day Training, Developmentally Disabled Services | 708 North Pearl, Milan, MO 63556 | 2007-04-04 |
| 1114008281 | Stephanie Alvera Granneman | Nurse Practitioner | 210 N Market St, Milan, MO 63556 | 2006-10-17 |
| 1801968979 | Daniel Hoelzel Crtt Inc | Durable Medical Equipment & Medical Supplies | 19269 Daisy Dr, Milan, MO 63556-0065 | 2006-11-14 |
| 1194856203 | Sullivan County Health Department | Case Management | 101 Hawthorne Dr, Milan, MO 63556-1017 | 2007-03-08 |
| 1790781136 | Sullivan County Ambulance District | Ambulance | 113 S Leewood Dr, # 1, Milan, MO 63556-1100 | 2005-06-21 |
| 1053440032 | Sheila F King | Speech-Language Pathologist | 373 S Market St, Milan, MO 63556-1182 | 2007-03-05 |
| 1407136393 | Ashley L Gardner | Speech-Language Pathologist | 373 S Market St, Milan, MO 63556-1182 | 2011-08-23 |
| 1487859120 | Ann E Mcdonald | Local Education Agency (LEA) | 373 S Market St, Milan, MO 63556-1182 | 2007-06-20 |
| 1053437806 | School Dist 2 Milan | Local Education Agency (LEA) | 373 S Market St, Milan, MO 63556-1182 | 2007-03-22 |
| Find all providers in zip 63556 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053972349 | Alanna Diamond | Emergency Medicine | One Hospital Drive Emergency Medicine M652 Dc029.10, Columbia, MO 65212-0001 | 2019-06-26 |
| 1013573146 | Michael Habhab | Emergency Medicine | 1 Hospital Dr Emergency Medicine M562 Dc029.10, Columbia, MO 65212-0001 | 2019-05-14 |
| 1043730716 | Ian James Becker | Emergency Medicine | 1 Hospital Dr # Dc029.10, Columbia, MO 65212-1000 | 2017-06-23 |
| 1649628454 | Sphere Medical Group | Emergency Medicine | 916 Olive St Fl 4, Saint Louis, MO 63101-1459 | 2016-06-02 |
| 1487002523 | Christopher Adam Waranch | Emergency Medicine | University of Missouri Columbia, Department of Emergency Medicine, Columbia, MO 65212-0001 | 2016-05-31 |
| 1306220488 | Andrea Marie-gioia Spangler | Emergency Medicine | 1235 E Cherokee St Dept Of, Springfield, MO 65804-2203 | 2015-07-17 |
| 1205219045 | Maria Christina Creel-bulos | Emergency Medicine | 660 South Euclid Avenue Cb 8072, St Louis, MO 63110 | 2015-06-29 |
| 1669853230 | Megan Litzau | Emergency Medicine | 615 S New Ballas Road, St Louis, MO 63141 | 2015-06-09 |
| 1366829426 | Bigeye Emergency Physicians LLC | Emergency Medicine | 10 South Hospital Deive, Fulton, MO 65251 | 2015-04-28 |
| 1972999225 | Timothy O Olatunde | Emergency Medicine | 4410 Wornall Road, Kansas City, MO 64111 | 2015-04-14 |
| 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.