MISSOURI BAPTIST HOSPITAL OF SULLIVAN (NPI# 1396755369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396755369 |
| Entity Type | Organization |
| Organization Name | MISSOURI BAPTIST HOSPITAL OF SULLIVAN |
| Other Organization Name | MISSOURI BAPTIST SULLIVAN HOSPITAL |
| Practice Address |
751 Sappington Bridge Rd Sullivan MO 63080-2354 |
| Practice Telephone | 5734684186 |
| Practice Fax Number | 5738602696 |
| Mailing Telephone | 5734681343 |
| Mailing Fax Number | 5738602696 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | MR. TONY SCHWARM II (PRESIDENT) |
| Authorized Official Telephone | 5734681343 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
Hospitals | ||
| Y | 275N00000X | Medicare Defined Swing Bed Unit | 355-24 | MO | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS-BLUE SHIELD | 108 | 01 | |
| MO | MI010565000 | 05 | |
| AETNA | 489665 | 01 | |
| MO | 540565009 | 05 | |
| BLUE CHOICE | 108 | 01 | |
| PREMIER PLUS | 260115 | 01 | |
| MO | 800565004 | 05 |
| Other Name | Type Code |
|---|---|
| Missouri Baptist Sullivan Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790953909 | Missouri Baptist Hospital of Sullivan | Obstetrics & Gynecology | 875 N Commercial Ave, Saint Clair, MO 63077-1118 | 2008-02-11 |
| 1396827408 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 102 Ozark Street, Suite B, Cuba, MO 65453-1664 | 2006-10-19 |
| 1487735445 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 510 West Main Street, Steelville, MO 65565 | 2006-10-18 |
| 1528676475 | Missouri Baptist Hospital of Sullivan | Clinical Medical Laboratory | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | 2020-07-16 |
| 1891246617 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 751 Sappington Bridge Rd, Administration, Sullivan, MO 63080-2354 | 2016-10-17 |
| 1083165807 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 510 W Main St, Steelville, MO 65565 | 2016-10-17 |
| 1184174567 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 240 College St, Bourbon, MO 65441-8308 | 2016-10-10 |
| 1689124166 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 102 Ozark Dr Ste B, Cuba, MO 65453-1664 | 2016-10-10 |
| 1851841332 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 965 Mattox Dr, Sullivan, MO 63080-2365 | 2016-10-10 |
| 1770764193 | Missouri Baptist Hospital of Sullivan | Family Medicine | 510 West Main Street, Steelville, MO 65565 | 2007-11-15 |
| Street Address |
751 SAPPINGTON BRIDGE RD |
| City | SULLIVAN |
| State | MO |
| Zip Code | 63080-2354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679598247 | Bc Missouri Emergency Physicians, LLP | Physician Assistant | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | 2006-07-13 |
| 1528676475 | Missouri Baptist Hospital of Sullivan | Clinical Medical Laboratory | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | 2020-07-16 |
| 1942841390 | Katherine M Jasper | Nurse Practitioner | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | 2019-10-07 |
| 1477034437 | Lisa Ann Nelson | Nurse Practitioner | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | 2018-08-27 |
| 1831613074 | Margaret Lacuesta | Nurse Practitioner | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | 2017-07-31 |
| 1891246617 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 751 Sappington Bridge Rd, Administration, Sullivan, MO 63080-2354 | 2016-10-17 |
| 1558729905 | Kelly Hinson | Nurse Practitioner | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | 2016-01-31 |
| 1881059202 | Megan Turnbough | Nurse Practitioner | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | 2015-12-30 |
| 1679941546 | Courtney Dulworth | Registered Nurse | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | 2015-09-09 |
| 1083019020 | Cinnamon Dale Michalik | Nurse Practitioner | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | 2014-11-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669896650 | Lindsay Nicole Arnette | Physical Therapist | 940 Mattox Drive, Meramec Nursing Center, Sullivan, MO 63080 | 2014-02-11 |
| 1407099500 | Victorian Manor of Sullivan | Assisted Living Facility | 1250 East Springfield Rd, Sullivan, MO 63080 | 2009-04-20 |
| 1578729992 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 123 Progress Parkway, Sullivan, MO 63080 | 2008-08-05 |
| 1386826089 | Sellers Family Chiropractic PC | Chiropractor | 405 Wal Mart Drive, Sullivan, MO 63080 | 2007-12-04 |
| 1740495282 | Tasha Marie Rodriguez | Physical Therapist | 107 Congress Dr., Sullivan, MO 63080 | 2007-05-10 |
| 1033261649 | Clyde William Sellers II | Chiropractor | 405 Walmart Dr., Sullivan, MO 63080 | 2007-01-17 |
| 1407954209 | Sara Skidmore | Occupational Therapist | 2022 Phoenix Drive, Sullivan, MO 63080 | 2006-09-20 |
| 1083724116 | Sharon A Titter | Physical Therapist | 107 Progress Dr, Sullivan, MO 63080 | 2006-08-30 |
| 1437135571 | Thanh Duy Vo | Pediatrics | 486 N Church St, Sullivan, MO 63080 | 2005-12-20 |
| 1508849316 | Air Evac Ems Inc | Ambulance | 673 Sappington Bridge Rd, Sullivan, MO 63080 | 2005-11-25 |
| Find all providers in zip 63080 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013054212 | Ste Genevieve County Memorial Hospital | Medicare Defined Swing Bed Unit | 800 Sainte Genevieve Dr, Ste Genevieve, MO 63670-1434 | 2007-01-30 |
| 1104801547 | Barton County Memorial Hospital | Medicare Defined Swing Bed Unit | 29 Nw 1st Ln, Lamar, MO 64759-8105 | 2005-12-08 |
| 1245220052 | Ray County Memorial Hospital | Medicare Defined Swing Bed Unit | 904 Wollard Blvd, Richmond, MO 64085-2229 | 2005-10-24 |
| 1083601330 | Western Missouri Medical Center | Medicare Defined Swing Bed Unit | 403 Burkarth Rd, Warrensburg, MO 64093 | 2005-10-03 |
| 1407469778 | Noble Health Fulton Inc. | Medicare Defined Swing Bed Unit | 10 S Hospital Dr, Fulton, MO 65251-2510 | 2020-08-26 |
| 1558985911 | Poplar Bluff Regional Medical Center LLC | Medicare Defined Swing Bed Unit | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2020-06-02 |
| 1568936995 | Mosaic Medical Center - Maryville | Medicare Defined Swing Bed Unit | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
| 1861861726 | Southeast Health Center of Reynolds LLC | Medicare Defined Swing Bed Unit | 100 Highway 21 N, Ellington, MO 63638-9409 | 2015-09-22 |
| 1023487162 | Southeast Health Center of Ripley County | Medicare Defined Swing Bed Unit | 109 Plum St, Doniphan, MO 63935-1277 | 2015-09-18 |
| 1093194888 | Southeast Health Center of Ripley County | Medicare Defined Swing Bed Unit | 109 Plum St, Doniphan, MO 63935-1277 | 2015-05-26 |
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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.