NPIMap

Putnam County Memorial Hospital

Organization Active NPI Rural Health Clinic/Center · Unionville, MO

NPI 1124125539 · NPPES record last updated Oct 21, 2016

Key facts

NPI
1124125539
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
PUTNAM COUNTY MEMORIAL HOSPITAL
Practice address
1926 Oak St
Unionville, MO 63565-1180
Phone
(660) 947-2425
Fax
(660) 947-7024
NPI assigned
Sep 20, 2006
Organization subpart
No

Authorized official

Name
Mrs. Rhonda Webber
Title
Accounts Payable
Phone
(660) 947-2411

Owners & managing parties with NPI records 3

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

Owned or controlled facilities with NPI records 1

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

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 2

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

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

Practitioners 14

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0906273Putnam County Rural Health Clinic
1926 Oak Street, Unionville, MO 63565		Provider-performed microscopyMar 19, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MO

Rural health clinic certification: CCN 263495

Legal name
PUTNAM COUNTY MEMORIAL HOSPITAL
Doing business as
PUTNAM COUNTY MEMORIAL HOSPITAL RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 10, 1996
Last certification
Oct 13, 2021
Ownership / control type
Non-profit – church related
Organization structure
Other · Non-profit
Enrollment address
1926 Oak St
Unionville, MO 63565-1180
Related CCNs
261305

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Howard Luscan
Individual 		Corporate Director
Board of Trustees President		 Nov 1, 2018
Nathan L Baughman
Individual 		Corporate Officer Oct 23, 2017
Corporate Director Oct 23, 2017
W-2 Managing Employee Oct 23, 2017
Lindsy L Peck
Individual 		W-2 Managing Employee Oct 1, 2014
Operational/Managerial Control Oct 1, 2014
Joetta Hunt
Individual 		Corporate Director
Board of Trustees Secretary		 Nov 1, 2018
Linda Valentine
Individual 		Corporate Director
Board of Trustees Member		 Nov 1, 2018
Rhonda Webber
Individual 		W-2 Managing Employee Feb 22, 2018
Putnam County Memorial Hospital
Organization · Unionville, MO
Non-profit 		Other Aug 1, 2000
Arlene G Pickens
Individual 		Corporate Officer Oct 23, 2017
Corporate Director Oct 23, 2017
W-2 Managing Employee Oct 23, 2017

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Putnam County Memorial Hospital
Unionville, MO · CCN 261305		 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 2000
Aug 1, 2000

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20060327000726 MO Part B Supplier - Clinic/Group Practice 7911915327 Receives reassigned benefits from 11 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Unionville, MO
O20100205000669 MO Part a Provider - Rural Health Clinic 7911915327 Practice locations: Unionville, MO

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/putnamm-2b5c1bdb

Specialties & licenses

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

Addresses

Primary practice location

1926 Oak St
Unionville, MO 63565-1180

Mailing address

1926 Oak St
PO Box 389
Unionville, MO 63565-1180
Phone (660) 947-2425

Other identifiers

IdentifierTypeStateIssuer
590322509MedicaidMO
0532713MedicaidIA

Other names

  • Putnam County Memorial Hospital Rural Health Clinic Doing business as

Other providers in Unionville, MO

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

Sources for this page

Verify at the official NPI Registry.