NPIMap

Organization Active NPI

Freeman-Oak Hill Health System

Doing business as Pink Door Boutique

  • Prosthetic/Orthotic Supplier
  • Joplin, MO
National Provider Identifier
1194972869
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
FREEMAN-OAK HILL HEALTH SYSTEM
Doing business as
Pink Door Boutique
Practice address
1532 W 32ND St
Suite 102
Joplin, MO 64804-1607
Phone
(417) 347-7465
Fax
(417) 347-6465
NPI assigned
Aug 25, 2008
Last updated
Nov 18, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
FREEMAN HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Authorized official

Name
Chris Walker
Title
Dir of Durable Medical Services
Phone
(417) 347-7417

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X NU Primary

Addresses

Primary practice location

1532 W 32ND St
Suite 102
Joplin, MO 64804-1607

Mailing address

1532 W 32ND St
Suite 102
Joplin, MO 64804-1607
Phone (417) 347-7465

Other identifiers 2

IdentifierTypeStateIssuer
1194972869MedicaidMO
100693570MedicaidOK

Other names 1

  • Pink Door Boutique Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930067709 MO DME Supplier - Medical Supply CompanyDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 8325942253 Practice locations: Joplin, MO

Other NPIs with the same Medicare PAC ID 13

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

View all 13

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Pink Door Boutique1532 W 32ND St, Joplin, MO 64804-1642(417) 347-7465 Breast Prostheses and/or Accessories|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Sep 1, 2005

National Provider Directory

National Provider Directory
Tax ID family
Freeman Clinc of Webb C20 organizations share this tax ID, including this one
Part of
Freeman Clinc of Webb C

Other organizations with this tax ID 14

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

View all 14

Locations

1532 W 32nd St
Ste 102
Joplin, MO 64804
Phone (417) 347-7465

Ownership & related parties

All facility ownership & control disclosures 9

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

FacilityTypeRoleSince
Freeman Neosho HospitalNeosho, MO, CCN 261331 Hospital Operational/Managerial Control Apr 1, 2006
Freeman Health SystemJoplin, MO, CCN 260137 Hospital Operational/Managerial Control Apr 1, 2006
Freeman Health SystemJoplin, MO, CCN 26S137 Hospital Operational/Managerial Control (100%) May 29, 2008
Freeman Health SystemJoplin, MO, CCN 26T137 Hospital Operational/Managerial Control May 29, 2008
Freeman Neosho HospitalNeosho, MO, CCN 26Z331 Hospital Operational/Managerial Control Jul 1, 2013
Freeman Fort Scott HospitalFort Scott, KS, CCN 170210 Hospital Operational/Managerial Control Jul 27, 2025
Freeman Home Care ServicesJoplin, MO, CCN 267160 Home health agency Operational/Managerial Control (100%) Apr 1, 2006
Freeman Neosho Physician GroupNeosho, MO, CCN 268722 Rural health clinic Operational/Managerial Control (100%) Feb 1, 2014
Freeman Clinic of AndersonAnderson, MO, CCN 268773 Rural health clinic Operational/Managerial Control (100%) Jul 1, 2018

Owned or controlled facilities with NPI records 10

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1194972869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 W 32ND ST",
            "address_2": "SUITE 102",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041607",
            "telephone_number": "417-347-7465",
            "fax_number": "417-347-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 W 32ND ST",
            "address_2": "SUITE 102",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041607",
            "telephone_number": "417-347-7465",
            "fax_number": "417-347-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEMAN-OAK HILL HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREEMAN HEALTH SYSTEM",
        "enumeration_date": "2008-08-25",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "DIR OF DURABLE MEDICAL SERVICES",
        "authorized_official_telephone_number": "417-347-7417"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194972869",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100693570",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pink Door Boutique",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pink Door Boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.