Missouri Delta Medical Center

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

NPI 1174789549 · NPPES record last updated Apr 15, 2026

Key facts

NPI
1174789549
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
MISSOURI DELTA MEDICAL CENTER
Practice address
123 Smith Ave
Sikeston, MO 63801-5239
Phone
(573) 471-0200
NPI assigned
Aug 5, 2008
Organization subpart
Yes
Parent organization (as reported)
MISSOURI DELTA MEDICAL CENTER

Authorized official

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

Owners & managing parties with NPI records 17

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

Owned or controlled facilities with NPI records 12

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

Other NPIs with the same Medicare PAC ID 17

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

Corporate family (same tax ID) 23

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

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

Facilities with the same owner 12

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

Practitioners 134

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

View all 134

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Rural health clinic certification: CCN 268635

Legal name
MISSOURI DELTA MEDICAL CENTER
Doing business as
SMITH STREET CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 1, 2008
Last certification
Oct 22, 2024
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Mar 30, 1942 in MO
Enrollment address
123 Smith Ave
Sikeston, MO 63801-5239
Related CCNs
260113

All disclosed owners & managing parties 4

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 Director
Ceo/President
Oct 1, 2010 100%
James D Henson
Individual
W-2 Managing Employee May 14, 2002
Missouri Delta Medical Center
Organization · Sikeston, MO
Non-profit
5% Or Greater Direct Ownership Interest Mar 30, 1966 100%
Gregory Carda
Individual
Corporate Officer
Cfo
Jan 27, 2015
W-2 Managing Employee
Cfo
Jan 27, 2015

All facility ownership & control disclosures 12

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

FacilityTypeRoleSince
Missouri Delta Medical Center
Sikeston, MO · CCN 260113
Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2002
Missouri Delta Medical Center
Sikeston, MO · CCN 26T113
Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 14, 2011
Missouri Delta Medical Center
Sikeston, MO · CCN 26S113
Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 14, 2011
Missouri Delta Express Care
Sikeston, MO · CCN 268591
Rural health clinic 5% Or Greater Direct Ownership Interest Sep 16, 2011
Community Care Center
Charleston, MO · CCN 263492
Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 23, 1996
Portageville Community Care Center
Portageville, MO · CCN 268698
Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
New Madrid Community Care Center
New Madrid, MO · CCN 268699
Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Benton Community Care Center
Benton, MO · CCN 268740
Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 1, 2016
Dexter Community Care Center
Dexter, MO · CCN 268739
Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2015
Chaffee Medical Clinic
Chaffee, MO · CCN 268766
Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2017
Malden Primary Care
Malden, MO · CCN 268804
Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2024
Caruthersville Medical Clinic
Caruthersville, MO · CCN 268810
Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2025

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20081110000109 MO Part a Provider - Rural Health Clinic 1355252891 Practice locations: Sikeston, MO

National Provider Directory

Tax ID family
Missouri Delta Medical Center (24 organizations share this tax ID)
Part of
Missouri Delta Medical Center

Specialties & licenses

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

Addresses

Primary practice location

123 Smith Ave
Sikeston, MO 63801-5239

Mailing address

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600

Other providers in Sikeston, MO

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

Sources for this page

Verify at the official NPI Registry.