Iron County Hospital District
Organization Active NPI Rural Health Clinic/Center · Pilot Knob, MO
NPI 1073799367 · NPPES record last updated Jul 31, 2025
Key facts
- NPI
- 1073799367
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- IRON COUNTY HOSPITAL DISTRICT
- Practice address
- 301 N Highway 21
Pilot Knob, MO 63663-7862 - Phone
- (573) 546-8051
- NPI assigned
- Jan 16, 2008
- Organization subpart
- No
Authorized official
- Name
- Brittney Mooney
- Title
- Cfo
- Phone
- (573) 546-8096
Owners & managing parties with NPI records 1
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Related certifications (CCN) 1
Practitioners 54
-
Zia M Ahmad, M.D., F.A.C.C.
-
Naeem Aslam, MD
-
Mehwish Bilal, M.D.
-
Misty Dawn Cain, FNP
-
Heather Cheaney, FNP
-
Cindy Lee Dulaney, FNP-BC
-
Gregg A. Ginsburg, M.D.
-
Bruce E Harrison, M.D.
-
Branda Irvin, FNP-C
-
Paul Robert Jones, M.D.
-
Paul S Moniz, DO
-
Jessica Dawn Nichols, FNP
-
Nikhat Salamat, M.D.
-
Kristi Dawn Skinner, MSN, APRN, ACNS-BC
-
Jennifer Leigh Vermaak, NURSE PRACTITIONER
-
Laura Ann Wallace, A.P.N
-
Alex Crane, PA
-
Dana R Day, M.D.
-
Michael Yankowitz, DPM
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D1084931 | Iron County Hospital Family Care Clinic | Certificate of waiver | Jun 5, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO
Rural health clinic certification: CCN 268642
- Legal name
- IRON COUNTY HOSPITAL DISTRICT
- Doing business as
- IRON COUNTY HOSPITAL FAMILY CARE CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jan 12, 2010
- Last certification
- Oct 2, 2023
- Ownership / control type
- Non-profit – church related
- Organization structure
- Government · Non-profit
- Enrollment address
- 301 N Hwy 21
Pilot Knob, MO 63663-0329 - Related CCNs
- 261336
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Iron County Hospital District |
Other | Feb 27, 2014 | 100% |
| Billie Jo Russell |
W-2 Managing Employee |
Dec 31, 2025 | |
| Brittany Mooney |
W-2 Managing Employee |
Sep 18, 2025 | |
| William Thompson |
Corporate Director |
May 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070517000093 | MO | Part B Supplier - Clinic/Group Practice | 0941207526 |
Receives reassigned benefits from 55 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Pilot Knob, MO |
| O20091008000706 | MO | Part a Provider - Rural Health Clinic | 0941207526 | Practice locations: Pilot Knob, MO |
National Provider Directory
Locations
350 E Walnut St
Ellington, MO 63638
Phone (573) 546-8008
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
301 N Highway 21
Pilot Knob, MO 63663-7862
Mailing address
PO Box 548
301 North Highway 21
Pilot Knob, MO 63663-0548
Phone (573) 546-1260
Other names
- IRON COUNTY HOSPITAL FAMILY CARE CLINIC
Other providers in Pilot Knob, MO
- Boonfu Boonyasai
- Vatana C. Boonyasai
- Harry Taylor Harness
- Jami Hedrick
- Iron County Ambulance District
- Iron County Hospital District
- Chelsea L Isgrig
- James Mathis, M.D.
- Cindy Kaye Larkin
- Robert Wayne Lefebvre
All providers in Pilot Knob, 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 Jul 31, 2025. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.