NPIMap

Organization Active NPI

General John J Pershing Memorial Hospital Association

Doing business as Applegate Medical Group

  • Rural Health Clinic/Center
  • Brookfield, MO
National Provider Identifier
1063705341
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GENERAL JOHN J PERSHING MEMORIAL HOSPITAL ASSOCIATION
Doing business as
Applegate Medical Group
Practice address
130 E Lockling St
Brookfield, MO 64628-2337
Phone
(660) 258-1288
Fax
(660) 258-4002
NPI assigned
May 19, 2011
Last updated
Nov 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Authorized official

Name
Mr. Kenneth E Baranski, CPA
Title
Cfo
Phone
(660) 258-1288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X MO Primary

Addresses

Primary practice location

130 E Lockling St
Brookfield, MO 64628-2337

Mailing address

125 E Lockling St
Brookfield, MO 64628-2367
Phone (660) 258-8237

Other identifiers 1

IdentifierTypeStateIssuer
26-8669OtherMORHC MEDICARE PROVIDER

Other names 1

  • Applegate Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050422000230 MO Part B Supplier - Clinic/Group Practice 2860306750 Receives reassigned benefits from 22 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brookfield, MO; Meadville, MO

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/23d7eb1d-294f-4546-883b-c856fcd53f34/

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": "1305763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1063705341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E LOCKLING ST",
            "city": "BROOKFIELD",
            "state": "MO",
            "postal_code": "646282367",
            "telephone_number": "660-258-8237",
            "fax_number": "660-258-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E LOCKLING ST",
            "city": "BROOKFIELD",
            "state": "MO",
            "postal_code": "646282337",
            "telephone_number": "660-258-1288",
            "fax_number": "660-258-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL JOHN J PERSHING MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-19",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "BARANSKI",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "660-258-1288",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RHC MEDICARE PROVIDER",
            "identifier": "26-8669",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Applegate Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Applegate Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.