NPIMap

Organization Active NPI

Salem Memorial Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Salem, MO
National Provider Identifier
1225008543
Registry record updated Feb 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
25234 Issued in MO
Legal business name
SALEM MEMORIAL HOSPITAL
Practice address
35629 Highway 72
Salem, MO 65560-7217
Phone
(573) 729-6626
NPI assigned
Jan 26, 2006
Last updated
Feb 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2010

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

Authorized official

Name
Mr. Dennis P Pryor
Title
Administrator
Phone
(573) 729-6626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 25234 MO Primary

Addresses

Primary practice location

35629 Highway 72
Salem, MO 65560-7217

Mailing address

PO Box 774
35629 Highway 72
Salem, MO 65560-0774
Phone (573) 729-6626

Other identifiers 1

IdentifierTypeStateIssuer
010570307MedicaidMO

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266796800000",
    "number": "1225008543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 774",
            "address_2": "35629 HIGHWAY 72",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655600774",
            "telephone_number": "573-729-6626",
            "fax_number": "573-729-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35629 HIGHWAY 72",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655607217",
            "telephone_number": "573-729-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2010-02-22",
        "status": "A",
        "authorized_official_last_name": "PRYOR",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-729-6626",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MO",
            "license": "25234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010570307",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2010; 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.