MADISON MEDICAL CENTER STOCKHOFF MEMORIAL NURSING HOME (NPI# 1750457586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750457586 |
| Entity Type | Organization |
| Organization Name | MADISON MEDICAL CENTER STOCKHOFF MEMORIAL NURSING HOME |
| Other Organization Name | MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOME |
| Practice Address |
611 West Main Street Fredericktown MO 63645 |
| Practice Telephone | 5737833341 |
| Practice Fax Number | 5737831096 |
| Mailing Telephone | 5737833341 |
| Mailing Fax Number | 5737831096 |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2012-05-30 |
| Authorized Official Name | MRS. LISA MARIE TWIDWELL (CFO) |
| Authorized Official Telephone | 5737833341 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 25619 | MO | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 580155109 | 05 |
| Other Name | Type Code |
|---|---|
| Madison Memorial Hospital Stockhoff Memorial Nursing Home | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649357229 | Madison Medical Center Stockhoff Memorial Nursing Home | Clinic/Center | 200 St. Mary, Pilot Knob, MO 63663-0523 | 2006-11-01 |
| 1467539031 | Madison Medical Center Stockhoff Memorial Nursing Home | Clinic/Center | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-01 |
| 1316013139 | Madison Medical Center Stockhoff Memorial Nursing Home | Medicare Defined Swing Bed Unit | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1215003041 | Madison Medical Center Stockhoff Memorial Nursing Home | Nursing Facility/Intermediate Care Facility | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1720163025 | Madison Medical Center Stockhoff Memorial Nursing Home | General Acute Care Hospital | 611 W Main St, Fredericktown, MO 63645-1111 | 2006-10-26 |
| Street Address |
611 WEST MAIN STREET |
| City | FREDERICKTOWN |
| State | MO |
| Zip Code | 63645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467539031 | Madison Medical Center Stockhoff Memorial Nursing Home | Clinic/Center | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-01 |
| 1235392309 | Humberto Jose Olivero Lara | Family Medicine | 611 West Main Street, Fredericktown, MO 63645 | 2008-07-08 |
| 1043490857 | Julie Marie Buford | Nurse Practitioner | 611 West Main Street, Suite E, Fredericktown, MO 63645-1111 | 2007-11-08 |
| 1003983859 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Pharmacy | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-29 |
| 1316013139 | Madison Medical Center Stockhoff Memorial Nursing Home | Medicare Defined Swing Bed Unit | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1225104045 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Homemaker | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1851467674 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Technician | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1306912134 | Madison Memorial Hospital Stockhoff Memorial Nursing Home | Ambulance | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| 1215003041 | Madison Medical Center Stockhoff Memorial Nursing Home | Nursing Facility/Intermediate Care Facility | 611 West Main Street, Fredericktown, MO 63645 | 2006-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093193880 | Emily Engers | Counselor | 206 W Marvin Ave, Fredericktown, MO 63645 | 2015-05-12 |
| 1871823955 | Covenant Care Services, LLC | Custodial Care Facility | 1610 W. Hwy 72, Fredericktown, MO 63645 | 2010-01-12 |
| 1518110279 | East Missouri Action Agency, Inc. | Clinic/Center | 806 West College Rd, Fredericktown, MO 63645 | 2008-10-28 |
| 1679737324 | Linda Carole Cravens | Dentist | 731 W Main St, Guy A Walker Dds, Fredericktown, MO 63645 | 2008-07-11 |
| 1629286976 | Community Health Care Associates, Inc | Social Worker | 735 West Main, Fredericktown, MO 63645 | 2007-05-18 |
| 1487749537 | Covenant Care Services, LLC | Registered Nurse | 120 S. Mine Lamotte, Fredericktown, MO 63645 | 2006-10-04 |
| 1215577945 | Modern Mental Health | Community/Behavioral Health | 151 South Main Street, Suite B, Fredericktown, MO 63645 | 2020-01-10 |
| 1619081593 | Angela R Menz | Nurse Practitioner | 611 W Main St, Fredericktown, MO 63645 | 2006-08-18 |
| 1811439227 | Bali Rae Hoover-richardson | Counselor | 1800 County Road 257, Fredericktown, MO 63645-0025 | 2016-11-16 |
| 1154673887 | Wagner Residential Care Inc | Assisted Living Facility | 320 N Chamber Dr, Fredericktown, MO 63645-0320 | 2012-10-04 |
| Find all providers in zip 63645 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669942108 | Discover Home Care | Home Health | 101 Kingsbury Blvd, Fredericktown, MO 63645-7959 | 2018-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033468 | Annette Presley | Home Health | 3008 Glade Ave, Saint Louis, MO 63136-1513 | 2020-11-04 |
| 1558962787 | Thoughti Inc. | Home Health | 911 Washington Ave Ste 433, Saint Louis, MO 63101-1271 | 2020-11-04 |
| 1942801345 | Homestead Health Care Ihs LLC | Home Health | 12405 Old Halls Ferry Rd Ste 100, Black Jack, MO 63033-4261 | 2020-11-03 |
| 1700487386 | Cwc Ihs, LLC | Home Health | 2347 Vorhof Dr, Saint Louis, MO 63136-5727 | 2020-11-02 |
| 1154922698 | Ericka Nycole Willis | Home Health | 4031 Dryden Ave, Saint Louis, MO 63115-2444 | 2020-11-02 |
| 1275133837 | Delicate Care, LLC | Home Health | 523 Coppinger Dr, Saint Louis, MO 63135-2111 | 2020-10-31 |
| 1629678818 | Modern Day Home Health Care | Home Health | 800 N Tucker Blvd Ste 453, Saint Louis, MO 63101-1000 | 2020-10-28 |
| 1114526894 | All About Love & Care Inc | Home Health | 2116 N Waterford Dr, Florissant, MO 63033-2301 | 2020-10-22 |
| 1639778764 | Icu Healthcare Solutions LLC | Home Health | 2441 Saint Cyr Rd, Jennings, MO 63136-5218 | 2020-10-20 |
| 1295334407 | Time of Serenity, LLC | Home Health | 5842 Macklind Ave, Saint Louis, MO 63109-3569 | 2020-10-19 |
| Find all providers with the same taxonomy | ||||
| City | FREDERICKTOWN |
| Zip Code | 63645 |
Please comment or provide details below to improve the information on MADISON MEDICAL CENTER STOCKHOFF MEMORIAL NURSING HOME.
| 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.