NPIMap

Organization Active NPI

Citizens Memorial Hospital District

  • Psychiatric Hospital Unit
  • Bolivar, MO
National Provider Identifier
1003945213
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
313-24 Issued in MO
Legal business name
CITIZENS MEMORIAL HOSPITAL DISTRICT
Practice address
1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone
(417) 326-6000
NPI assigned
Mar 5, 2007
Last updated
Oct 15, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CITIZENS MEMORIAL HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Renee Marie Meyer
Title
Cfo
Phone
(417) 328-6258

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 313-24 MO Primary

Addresses

Primary practice location

1500 N Oakland Ave
Bolivar, MO 65613-3011

Mailing address

1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone (417) 326-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080418000400 MO Part A Provider - Hospital 2769574433 Practice locations: Bolivar, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003945213. Details of each certification follow.

Hospital certification: CCN 26S195

Legal name
CITIZENS MEMORIAL HOSPITAL DISTRICT
Doing business as
CITIZENS MEMORIAL HOSPITAL
Organization structure
OtherNon-profit
Enrollment address
1500 N Oakland Ave
Bolivar, MO 65613-3011
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Citizens Memorial District12 organizations share this tax ID, including this one
Part of
Citizens Memorial District

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 16

Organizations listed as members of this organization in the National Provider Directory.

View all 16

Networks

  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Corey Rich Individual Corporate OfficerBoard Member Nov 21, 2017
Corporate DirectorBoard Member Nov 21, 2017
Robin R Sechler Individual Corporate OfficerBoard Member Dec 20, 2011
Corporate DirectorBoard Member Dec 20, 2011
Michael Calhoun Individual Corporate OfficerCeo Jan 1, 2022
W-2 Managing EmployeeCeo Jan 1, 2022
Citizens Memorial Hospital District Organization, Bolivar, MO Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 1981 100%
Operational/Managerial Control Aug 1, 1981 100%
Gary D Fulbright Individual Corporate OfficerCeo Jan 1, 2020
W-2 Managing EmployeeCeo Oct 1, 1984
Harold D Berry Individual Corporate OfficerBoard Member Mar 20, 2012
Corporate DirectorBoard Member Mar 20, 2012
John Kallenbach Individual Corporate DirectorBoard Member Jul 17, 2018
Eran T Dawson Individual Corporate OfficerAssistant Secretary of the Board Jan 1, 2022
Renee M Meyer Individual Corporate OfficerBoard Treasurer Jan 1, 2020
W-2 Managing EmployeeCfo Jan 1, 2020
Kerry P Douglas Individual Corporate OfficerBoard Member Apr 5, 2011
Corporate DirectorBoard Member Apr 5, 2011

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 18

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Citizens Memorial HospitalBolivar, MO, CCN 260195 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 1981
Aug 1, 1981
Citizens Memorial HospitalBolivar, MO, CCN 26U195 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 1981
Aug 1, 1981
Ellett Memorial HospitalAppleton City, MO, CCN 261301 Hospital Operational/Managerial Control Nov 1, 2013
Ellett Memorial HospitalAppleton City, MO, CCN 26Z301 Hospital Operational/Managerial Control (75%) Jun 1, 2018
Ac Rural Health ClinicAppleton City, MO, CCN 268593 Rural health clinic Operational/Managerial Control (75%) Jun 1, 2018
Humansville Family Medical CenterHumansville, MO, CCN 263976 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 3, 1990
Jul 3, 1990
Pleasant Hope Family Medical CenterPleasant Hope, MO, CCN 268552 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 14, 2000
Oct 14, 2000
Butterfield Park Medical CenterBolivar, MO, CCN 268553 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 1991
Oct 1, 1991
Dade County Family Medical CenterGreenfield, MO, CCN 263411 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Dec 1, 1992
Dec 1, 1992
Stockton Family Medical CenterStockton, MO, CCN 263977 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Aug 1, 1994
Jan 1, 2007
Ash Grove Family Medical CenterAsh Grove, MO, CCN 263471 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 1, 1994
Mar 1, 1994
CMH OB/GYN and Pediatric ClinicBolivar, MO, CCN 268554 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 2, 2001
Mar 2, 2001
Dallas County Family Medical CenterBuffalo, MO, CCN 263482 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 1, 1995
Nov 1, 1995
Southside Medical CenterBolivar, MO, CCN 268668 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 2011
Aug 1, 2011
Bolivar Family Care CenterBolivar, MO, CCN 268694 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2013
Oct 1, 2013
CMH Osceola Medical CenterOsceola, MO, CCN 268727 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 1, 2014
Nov 1, 2014
CMH El Dorado Springs Medical CenterEl Dorado Springs, MO, CCN 268751 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 3, 2017
Jan 3, 2017
CMH Willard Medical CenterWillard, MO, CCN 268791 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 6, 2021
Dec 6, 2021

Owned or controlled facilities with NPI records 18

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Citizens Memorial Healthcare

    dba Bolivar Family Care Center

    • Rural Health Clinic/Center
    • Bolivar, MO
    • NPI 1063588960

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Southside Medical Center

    • Rural Health Clinic/Center
    • Bolivar, MO
    • NPI 1407141153

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Ash Grove Family Medical Center

    • Rural Health Clinic/Center
    • Ash Grove, MO
    • NPI 1417161449

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Stockton Family Medical Center

    • Rural Health Clinic/Center
    • Stockton, MO
    • NPI 1447464227

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Humansville Family Medical Center

    • Rural Health Clinic/Center
    • Humansville, MO
    • NPI 1508070269

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba CMH Willard Medical Center

    • Rural Health Clinic/Center
    • Willard, MO
    • NPI 1568127397

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba CMH Osceola Medical Center

    • Rural Health Clinic/Center
    • Osceola, MO
    • NPI 1578961454

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Dallas County Family Medical Center

    • Rural Health Clinic/Center
    • Buffalo, MO
    • NPI 1609080571

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Dade County Family Medical Center

    • Rural Health Clinic/Center
    • Greenfield, MO
    • NPI 1699989350

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Pleasant Hope Family Medical Center

    • Rural Health Clinic/Center
    • Pleasant Hope, MO
    • NPI 1740494541

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Butterfield Park Medical Center

    • Rural Health Clinic/Center
    • Bolivar, MO
    • NPI 1831303502

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba CMH El Dorado Springs Medical Center

    • Rural Health Clinic/Center
    • El Dorado Springs, MO
    • NPI 1851834659

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
View all 18

Facilities with the same owner 18

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 18

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1003945213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-326-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-326-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITIZENS MEMORIAL HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITIZENS MEMORIAL HOSPITAL DISTRICT",
        "enumeration_date": "2007-03-05",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "417-328-6258"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "MO",
            "license": "313-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

Verify at the official NPI Registry.