NPIMap

Organization Active NPI

Salem Memorial Hospital

  • Ambulance
  • Salem, MO
National Provider Identifier
1053382382
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
25234 Issued in MO
Legal business name
SALEM MEMORIAL HOSPITAL
Practice address
35629 Highway 72
35629 Highway 72
Salem, MO 65560-7217
Phone
(573) 729-6626
NPI assigned
Jan 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Authorized official

Name
Brooke Bollman
Title
Ceo
Phone
(573) 739-1927

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 25234 MO Primary

Addresses

Primary practice location

35629 Highway 72
35629 Highway 72
Salem, MO 65560-7217

Mailing address

PO Box 774
35629 Highway 72
Salem, MO 65560-0774
Phone (573) 729-6626

Other identifiers 1

IdentifierTypeStateIssuer
800570301MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Salem Memorial Hosp5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/7fa95236-8ac0-416b-a8ed-2e866ba26ee3/

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775433600000",
    "number": "1053382382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 774",
            "address_2": "35629 HIGHWAY 72",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655600774",
            "telephone_number": "573-729-6626",
            "fax_number": "573-729-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35629 HIGHWAY 72",
            "address_2": "35629 HIGHWAY 72",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655607217",
            "telephone_number": "573-729-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A",
        "authorized_official_last_name": "BOLLMAN",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-739-1927"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MO",
            "license": "25234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800570301",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.