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Harrison County Community Hospital District

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

NPI 1154645745 · NPPES record last updated Sep 21, 2021

Key facts

NPI
1154645745
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
HARRISON COUNTY COMMUNITY HOSPITAL DISTRICT
Practice address
3202 Miller St
Bethany, MO 64424-2713
Phone
(660) 425-3154
Fax
(660) 425-6663
NPI assigned
Mar 25, 2010
Organization subpart
Yes
Parent organization (as reported)
HARRISON COUNTY COMMUNITY HOSPITAL DISTRICT

Authorized official

Name
Christina Gillespie
Title
Chief Executive Officer
Phone
(660) 425-2211

Owners & managing parties with NPI records 5

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

Owned or controlled facilities with NPI records 3

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

Other NPIs on the same Medicare enrollment 5

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

Other NPIs with the same Medicare PAC ID 4

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

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 36

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

View all 36

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
26D0444790HCCH Medical Clinic
3202 Miller Street, Bethany, MO 64424		Certificate of waiverAug 31, 2026

Medicare participation

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

Rural health clinic certification: CCN 268649

Legal name
HARRISON COUNTY COMMUNITY HOSPITAL DISTRICT
Doing business as
HCCH MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 3, 2010
Last certification
Apr 6, 2021
Ownership / control type
Non-profit – church related
Organization structure
Government · Non-profit
Enrollment address
3202 Miller St
Bethany, MO 64424-2713

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Christina Gillespie
Individual 		Corporate Officer
Chief Executive Officer		 Jan 30, 2017 100%
W-2 Managing Employee
Chief Executive Officer		 Jan 30, 2017 100%
Operational/Managerial Control
Chief Executive Officer		 Jan 30, 2017 100%
Sheila Robertson
Individual 		Corporate Director May 3, 2010
Kenneth Chad Lambert
Individual 		W-2 Managing Employee
MD;		 Sep 24, 2012
Alicia Hendren
Individual 		Corporate Officer
Chief Operating Officer		 Nov 23, 1998
Corporate Director
Chief Operating Officer		 Nov 23, 1998
W-2 Managing Employee
Chief Operating Officer		 Nov 23, 1998
Harrison County Community Hospital District
Organization · Bethany, MO 		5% Or Greater Direct Ownership Interest May 3, 2010 100%
Operational/Managerial Control May 3, 2010 100%
Glenda Ellis
Individual 		Corporate Director
Director		 Apr 5, 2016 100%
Amanda Gruver
Individual 		W-2 Managing Employee
Administrative Assistant		 May 1, 2025
Jamie L Smith
Individual 		Corporate Director
Business Office Manager		 Sep 28, 2010
W-2 Managing Employee Sep 28, 2010
Linda Eivins
Individual 		Operational/Managerial Control
Secretary on Board of Directors		 Jan 1, 2020
Alan Hamilton
Individual 		Corporate Director
Board Member		 Jan 1, 2019
Glenn Cox
Individual 		Corporate Director May 3, 2010
Kelvin Cox
Individual 		Operational/Managerial Control
Board of Director		 Oct 1, 2024
Renee Fordyce
Individual 		Corporate Director May 23, 2011

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Harrison County Community Hospital
Bethany, MO · CCN 261312		 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2001
Oct 1, 2001
North Harrison Medical Clinic
Eagleville, MO · CCN 268714		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 14, 2014
Jul 14, 2014
HCCH Pattonsburg Medical Clinic
Pattonsburg, MO · CCN 268813		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 1, 2025
Jun 1, 2025

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040907001047 MO Part B Supplier - Clinic/Group Practice 4587630926 Receives reassigned benefits from 33 practitioners
6 other NPIs on this enrollment
Practice locations: Bethany, MO; Eagleville, MO; Pattonsburg, MO
O20110929000628 MO Part a Provider - Rural Health Clinic 4587630926 Practice locations: Bethany, MO

National Provider Directory

Part of
North Missouri Emerg Phys

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

3202 Miller St
Bethany, MO 64424-2713

Mailing address

3202 Miller St
Bethany, MO 64424-2713
Phone (660) 425-3154

Other identifiers

IdentifierTypeStateIssuer
598581601MedicaidMO
43650011OtherMOBLUE CROSS BLUE SHIELD

Other names

  • Bethany Medical Clinic Doing business as
  • HCCH Medical Clinic Doing business as

Other providers in Bethany, MO

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

Sources for this page

Verify at the official NPI Registry.