General John J Pershing Memorial Hospital Association

Key facts

NPI: 1063705341
Entity type: Organization (NPI type 2)
Primary specialty: Rural Health Clinic/Center 261QR1300X
Legal business name: GENERAL JOHN J PERSHING MEMORIAL HOSPITAL ASSOCIATION
Practice address: 130 E Lockling St
Brookfield, MO 64628-2337
Phone: (660) 258-1288
Fax: (660) 258-4002
NPI assigned: May 19, 2011
Organization subpart: No

Authorized official

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

Other NPIs on the same Medicare enrollment 3

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

General John J Pershing Memorial Hospital Association Rural Health Clinic/Center · Meadville, MO · NPI 1285995944

Same enrollment O20050422000230
General John J Pershing Memorial Hospital Association Critical Access Hospital · Brookfield, MO · NPI 1417991159

Same enrollment O20050422000230
General John J Pershing Memorial Hospital Association Rural Health Clinic/Center · Brookfield, MO · NPI 1487616256

Same enrollment O20050422000230

Member of 1

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

General John J Pershing Memorial Hospital Association Rural Health Clinic/Center · Brookfield, MO · NPI 1487616256

NPD member Member Of

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Irene Newman Parsonson, FNP Family Nurse Practitioner · Brookfield, MO · NPI 1932275286

NPD

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MO

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
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

National Provider Directory

Locations

130 E Lockling St
Brookfield, MO 64628
Phone (660) 258-1050

Interoperability endpoints

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

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Rural Health Clinic/Center	261QR1300X		MO	Yes

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

Identifier	Type	State	Issuer
26-8669	Other	MO	RHC MEDICARE PROVIDER

Other names

Applegate Medical Group Doing business as

Other providers in Brookfield, MO

All providers in Brookfield, MO · Rural Health Clinic/Center in Missouri

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.