NPIMap

Organization Active NPI

Missouri Delta Medical Center

Doing business as Missouri Delta Primary Care

  • Rural Health Clinic/Center
  • Sikeston, MO
National Provider Identifier
1134430176
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MISSOURI DELTA MEDICAL CENTER
Doing business as
Missouri Delta Primary Care
Practice address
102 Hospitality Dr
Sikeston, MO 63801-9382
Phone
(573) 471-0200
Fax
(573) 471-7559
NPI assigned
Jun 24, 2010
Last updated
Apr 15, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MISSOURI DELTA MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Authorized official

Name
Jason Schrumpf
Title
Ceo/President
Phone
(573) 472-7601

Specialties & licenses 1

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

Addresses

Primary practice location

102 Hospitality Dr
Sikeston, MO 63801-9382

Mailing address

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 472-7333

Other names 1

  • Missouri Delta Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100713000324 MO Part A Provider - Rural Health Clinic 1355252891 Practice locations: Sikeston, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1134430176. Details of each certification follow.

Rural health clinic certification: CCN 268660

Legal name
MISSOURI DELTA MEDICAL CENTER
Doing business as
MISSOURI DELTA PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 18, 2011
Last certification
Oct 22, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Mar 13, 1942 in MO
Enrollment address
102 Hospitality Dr
Sikeston, MO 63801-9382
Related CCNs
260113

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

Other NPIs with the same Medicare PAC ID 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Missouri Delta Med Ctr27 organizations share this tax ID, including this one
Part of
Missouri Delta Med Ctr

Other organizations with this tax ID 26

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

View all 26

Locations

135 Plaza Dr
Ste 102
Sikeston, MO 63801
Phone (573) 264-2273

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Jason M Schrumpf Individual Corporate OfficerCeo Jan 1, 2015
W-2 Managing EmployeeCeo Jan 1, 2015
Bartholomew Grant Individual Corporate DirectorBoard Member Jan 12, 2016
Britton McConnell Individual Corporate DirectorBoard Member Jan 8, 2008
James D Henson Individual Corporate OfficerCoo Jan 1, 2022
Corporate DirectorCoo Jan 1, 2022
W-2 Managing EmployeeCoo Jan 1, 2022
Robert M Macgillivray Individual Corporate DirectorBoard Member Jan 8, 2019
David Jones Individual Corporate DirectorBoard Member Jan 14, 2020
Brian Menz Individual Corporate DirectorBoard Member Jan 11, 2000
Michael Jones Individual Corporate DirectorBoard Member Jan 12, 2010
Daniel Lape Individual Corporate DirectorBoard Member Jan 12, 2016
Julie Aycock Individual Corporate DirectorBoard Member Jan 12, 2021
Dwight Bizzell Individual Corporate DirectorBoard Member Jan 10, 2017
Edward E Dement Individual Corporate DirectorBoard Member Jan 12, 2010
Michael Marshall Individual Corporate DirectorBoard Member Jan 8, 2019
John Bollinger Individual Corporate DirectorBoard Member Jan 11, 2011
Tammy Burch Individual Corporate DirectorBoard Member Jan 8, 2019
Charles D Jennings Individual Corporate DirectorBoard Member Jan 8, 2008
Brett Matthews Individual Corporate DirectorBoard Member Jan 14, 2020
Jeff Partridge Individual Corporate DirectorBoard Member Jan 14, 2014
Gregory Carda Individual Corporate OfficerCfo Jan 27, 2015
W-2 Managing Employee Jan 27, 2015
Leven Cox Individual Corporate DirectorBoard Member Jan 10, 2017
Matthew Tanner Individual Corporate DirectorBoard Member Jan 12, 2016
Matthew Drake Individual Corporate DirectorBoard Member Jan 12, 2016

All facility ownership & control disclosures 13

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

FacilityTypeRoleSince
Missouri Delta Medical CenterSikeston, MO, CCN 260113 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2002
Missouri Delta Medical CenterSikeston, MO, CCN 26T113 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 14, 2011
Missouri Delta Medical CenterSikeston, MO, CCN 26S113 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 14, 2011
Missouri Delta Express CareSikeston, MO, CCN 268591 Rural health clinic 5% Or Greater Direct Ownership Interest Sep 16, 2011
Smith Street ClinicSikeston, MO, CCN 268635 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 30, 1966
Community Care CenterCharleston, MO, CCN 263492 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 23, 1996
Portageville Community Care CenterPortageville, MO, CCN 268698 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
New Madrid Community Care CenterNew Madrid, MO, CCN 268699 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Benton Community Care CenterBenton, MO, CCN 268740 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Dexter Community Care CenterDexter, MO, CCN 268739 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2015
Chaffee Medical ClinicChaffee, MO, CCN 268766 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2017
Malden Primary CareMalden, MO, CCN 268804 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2024
Caruthersville Medical ClinicCaruthersville, MO, CCN 268810 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2025

Owned or controlled facilities with NPI records 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1134430176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-472-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HOSPITALITY DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638019382",
            "telephone_number": "573-471-0200",
            "fax_number": "573-471-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI DELTA MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSOURI DELTA MEDICAL CENTER",
        "enumeration_date": "2010-06-24",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "SCHRUMPF",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "573-472-7601"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Missouri Delta Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Missouri Delta Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sikeston, MO

Sources for this page

Verify at the official NPI Registry.