NPIMap

Organization Active NPI

Ste Genevieve County Memorial Hospital

Doing business as Bloomsdale Family Health Care

  • Rural Health Clinic/Center
  • Bloomsdale, MO
National Provider Identifier
1184658387
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
STE GENEVIEVE COUNTY MEMORIAL HOSPITAL
Doing business as
Bloomsdale Family Health Care
Bloomsdale Family Health Center
Practice address
255 Boderman
Bloomsdale, MO 63627-9099
Phone
(573) 483-9492
NPI assigned
Jul 11, 2006
Last updated
Sep 18, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
STE GENEVIEVE COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Authorized official

Name
Scott Griffin
Title
Revenue Cycle Director
Phone
(573) 883-4473

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

255 Boderman
Bloomsdale, MO 63627-9099

Mailing address

800 Ste Genevieve Dr
Ste Genevieve, MO 63670-1434
Phone (573) 883-4477

Other identifiers 1

IdentifierTypeStateIssuer
CC8331OtherMORAILROAD MEDICARE

Other names 2

  • Bloomsdale Family Health Care Doing business as
  • Bloomsdale Family Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040102000645 MO Part B Supplier - Clinic/Group Practice 3274432802 Receives reassigned benefits from 66 practitioners
4 other NPIs on this enrollment
Practice locations: Bloomsdale, MO; Ste Genevieve, MO
O20091006000058 MO Part A Provider - Rural Health Clinic 3274432802 Practice locations: Bloomsdale, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184658387. Details of each certification follow.

Rural health clinic certification: CCN 268647

Legal name
STE GENEVIEVE COUNTY MEMORIAL HOSPITAL
Doing business as
BLOOMSDALE FAMILY HEALTH CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 15, 2010
Last certification
Feb 21, 2024
Ownership / control type
2A
Organization structure
GovernmentNon-profit
Enrollment address
255 Boderman
Bloomsdale, MO 63627-9099
Related CCNs
261330

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

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 4

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0989950Bloomsdale Family Health Care255 Boderman Lane, Bloomsdale, MO 63627Certificate of waiverApr 26, 2028

National Provider Directory

National Provider Directory
Part of
Mvo

Locations

255 Boderman
Ste 1C
Bloomsdale, MO 63627
Phone (573) 883-4473

255 Boderman
Ste 1D
Bloomsdale, MO 63627

900 Park Dr
Sainte Genevieve, MO 63670

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Tracy a Bonnell Individual Corporate DirectorDirector- Central Billing Office Sep 1, 2023
Rachel L Dallas Individual W-2 Managing Employee Apr 22, 2022
Amanda Wolk Individual Corporate DirectorDirector Phys Central Billing Jun 1, 2016
Ste Genevieve County Memorial Hospital Organization, Ste Genevieve, MO 5% Or Greater Direct Ownership Interest Nov 1, 2000 100%
Operational/Managerial Control Nov 1, 2000
John Schmidt Individual Corporate OfficerChief Financial Officer May 1, 2023

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Ste Genevieve County Memorial HospitalSainte Genevieve, MO, CCN 261330 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1969
Ste Genevieve County Memorial HospitalSainte Genevieve, MO, CCN 26Z330 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1969
Pine Drive Medical CentreSte Genevieve, MO, CCN 263439 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 2, 2004
Apple Kids PediatricsSte Genevieve, MO, CCN 268622 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 8, 1996
Jan 8, 1997
Women's Health CenterSte Genevieve, MO, CCN 268623 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 2, 2008
Jun 1, 2008
Family Health Care Pointe BasseSainte Genevieve, MO, CCN 268580 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2004
Apr 1, 2004
Plaza Family Health CareSte Genevieve, MO, CCN 268744 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2016

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 71

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1184658387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 STE GENEVIEVE DR",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636701434",
            "telephone_number": "573-883-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 BODERMAN",
            "city": "BLOOMSDALE",
            "state": "MO",
            "postal_code": "636279099",
            "telephone_number": "573-483-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STE GENEVIEVE COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STE GENEVIEVE COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2006-07-11",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "573-883-4473"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC8331",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bloomsdale Family Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bloomsdale Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bloomsdale Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomsdale, MO

Sources for this page

Verify at the official NPI Registry.