PEMISCOT COUNTY MEMORIAL HOSPITAL (NPI# 1699873372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699873372 |
| Entity Type | Organization |
| Organization Name | PEMISCOT COUNTY MEMORIAL HOSPITAL |
| Other Organization Name | PORTAGEVILLE PRIMARY CARE CENTER |
| Practice Address |
314 E Main St Portageville MO 63873-1616 |
| Practice Telephone | 5733793777 |
| Practice Fax Number | 5733799331 |
| Mailing Telephone | 5733793777 |
| Mailing Fax Number | 5733799331 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-05-12 |
| Authorized Official Name | MARK R DAVIS (CEO) |
| 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 | 596948109 | 05 |
| Other Name | Type Code |
|---|---|
| Portageville Primary Care Center | 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 |
314 E MAIN ST |
| City | PORTAGEVILLE |
| State | MO |
| Zip Code | 63873-1616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194093526 | Health Facilities Rehab Services Inc | Clinic/Center | 314 E Main St, Portageville, MO 63873-1616 | 2011-12-13 |
| 1780803916 | Southeast Missouri Health Network | Clinic/Center | 314 E Main St, Portageville, MO 63873-1616 | 2007-04-25 |
| 1629115670 | Dennis Reed | Physician Assistant | 314 E Main St, Portageville, MO 63873-1616 | 2007-01-31 |
| 1669589677 | Ralph Kelley | Family Medicine | 314 E Main St, Portageville, MO 63873-1616 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801158357 | Mindy Leigh French | Speech-Language Pathologist | 100 W 12th St, Portageville, MO 63873-1036 | 2012-06-11 |
| 1689299372 | Life Continues LLC | Community/Behavioral Health | 412 W 5th St, Portageville, MO 63873-1108 | 2020-06-09 |
| 1558574988 | Lee Kellams | Speech-Language Pathologist | 500 W 5th St, Portageville, MO 63873-1147 | 2007-05-08 |
| 1902910300 | Mary Samples | Speech-Language Pathologist | 904 King Ave, Portageville, MO 63873-1378 | 2006-08-19 |
| 1093858714 | Portageville School District | Local Education Agency (LEA) | 904 King Ave, Portageville, MO 63873-1378 | 2007-02-14 |
| 1871593905 | Lorna A Turnage | Clinic/Center | 203 E 3rd St, Portageville, MO 63873-1401 | 2005-07-29 |
| 1730622697 | Lorna Turnage | Family Medicine | 203 E 3rd St, Portageville, MO 63873-1401 | 2016-11-28 |
| 1841465671 | A Plus Family Clinic | Family Medicine | 203 E 3rd St, Portageville, MO 63873-1401 | 2008-04-23 |
| 1518968296 | Lorna Turnage | Family Medicine | 203 E 3rd St, Portageville, MO 63873-1401 | 2005-08-03 |
| 1053307975 | Andrew Ernest Painter | Family Medicine | 204 E 3rd St, Portageville, MO 63873-1402 | 2005-09-26 |
| Find all providers in zip 63873 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| 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 | ||||
| City | PORTAGEVILLE |
| Zip Code | 63873 |
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.