NPIMap

Organization Active NPI

Washington County Memorial Hospital

  • Rural Health Clinic/Center
  • Potosi, MO
National Provider Identifier
1144238171
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WASHINGTON COUNTY MEMORIAL HOSPITAL
Doing business as
HEALTHWAY PRIMARY CARE CLINIC
Practice address
200 Health Way Dr
Potosi, MO 63664-1434
Phone
(573) 438-2977
Fax
(573) 438-2874
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Authorized official

Name
Debra A Pratt
Title
Cfo
Phone
(573) 438-5451

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

200 Health Way Dr
Potosi, MO 63664-1434

Mailing address

200 Health Way Dr
Potosi, MO 63664-1434
Phone (573) 438-2977

Other identifiers 1

IdentifierTypeStateIssuer
506896703MedicaidMO

Other names 1

  • HEALTHWAY PRIMARY CARE CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Washington County Memor8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598486400000",
    "number": "1144238171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HEALTH WAY DR",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636641434",
            "telephone_number": "573-438-2977",
            "fax_number": "573-438-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HEALTH WAY DR",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636641434",
            "telephone_number": "573-438-2977",
            "fax_number": "573-438-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-438-5451"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506896703",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTHWAY PRIMARY CARE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HEALTHWAY PRIMARY CARE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Potosi, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.