NPIMap

Organization Active NPI

Ray County Memorial Hospital

  • Critical Access Hospital
  • Richmond, MO
National Provider Identifier
1245220052
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
RAY COUNTY MEMORIAL HOSPITAL
Practice address
904 Wollard Blvd
Richmond, MO 64085-2229
Phone
(816) 470-5432
Fax
(816) 470-8382
NPI assigned
Oct 24, 2005
Last updated
May 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Authorized official

Name
Cynthia J Thornberry
Title
Director of Revenue Cycle
Phone
(816) 470-7320

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital Clinic/Center 261QC0050X NU
Medicare Defined Swing Bed Hospital Unit 275N00000X NU
Critical Access Hospital 282NC0060X NU Primary

Addresses

Primary practice location

904 Wollard Blvd
Richmond, MO 64085-2229

Mailing address

904 Wollard Blvd
Richmond, MO 64085-2229
Phone (816) 470-5432

Other identifiers 7

IdentifierTypeStateIssuer
540491701MedicaidMO
90052014OtherBLUE CROSS -UB
010491702MedicaidMO
6350600OtherAETNA
114311OtherPREFERRED CARE HEALTHLINK
90267015OtherSNF
01514018OtherBLUE CROSS-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040225001164 MO Part B Supplier - Clinic/Group Practice 4688560634 Receives reassigned benefits from 76 practitioners
Practice locations: Richmond, MO
O20081014000195 MO Part A Provider - Critical Access Hospital 4688560634 Receives reassigned benefits from 75 practitioners
Practice locations: Richmond, MO
O20081014000257 MO Part A Provider - Critical Access Hospital 4688560634 Practice locations: Richmond, MO

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1245220052. Details of each certification follow.

Hospital certification: CCN 261327

Legal name
RAY COUNTY MEMORIAL HOSPITAL
Doing business as
RAY COUNTY MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 1, 2005
Last certification
Jan 31, 2024
Beds
25
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
904 Wollard Blvd
Richmond, MO 64085-2229
Main/Primary Hospital Location

Hospital certification: CCN 26Z327

Legal name
RAY COUNTY MEMORIAL HOSPITAL
Doing business as
RAY COUNTY MEMORIAL HOSPITAL
Organization structure
GovernmentNon-profit
Enrollment address
904 Wollard Blvd
Richmond, MO 64085-2229
Other Hospital Practice Location

Hospital certification: CCN 260122

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
RAY COUNTY MEMORIAL HOSPITAL
Certification status
Terminated Other: provider status change, Jul 31, 2005
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 19, 2002
Beds
49
Ownership / control type
Local
Facility address
904 Wollard Blvd
Richmond, MO 64085

Care Compare: Hospital

Medicare Care Compare
Listed as
Ray County Memorial HospitalCCN 261327 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
26D0652220Ray County Memorial Hospital904 Wollard Blvd, Richmond, MO 64085ComplianceJun 26, 2026

National Provider Directory

National Provider Directory

Locations

904 Wollard Blvd
Richmond, MO 64085
Phone (816) 470-5432

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
Lisa M Dekezel Individual Corporate OfficerCeo Jan 16, 2026
W-2 Managing EmployeeCeo Jan 16, 2026
Operational/Managerial ControlCeo Jan 16, 2026
Annetta Slover Individual Corporate OfficerDirector of Revenue Cycle Feb 10, 2026
W-2 Managing EmployeeDirector of Revenue Cycle Feb 10, 2026
Operational/Managerial ControlDirector of Revenue Cycle Feb 10, 2026
Ray County Memorial Hospital Organization, Richmond, MO Non-profit Operational/Managerial Control Jun 27, 1966
Stephanie Smith Individual Corporate OfficerInterim Cfo Jul 1, 2025
W-2 Managing EmployeeInterim Cfo Jul 1, 2025
Operational/Managerial ControlInterim Cfo Jul 1, 2025
Earl Sheehy Individual Corporate OfficerInterim Ceo Jun 30, 2025
W-2 Managing EmployeeInterim Ceo Jun 30, 2025
Operational/Managerial ControlInterim Ceo Jun 30, 2025

Practitioners & affiliated clinicians

Practitioners 80

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 80

Affiliated clinicians 87

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 87

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1245220052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 WOLLARD BLVD",
            "city": "RICHMOND",
            "state": "MO",
            "postal_code": "640852229",
            "telephone_number": "816-470-5432",
            "fax_number": "816-470-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 WOLLARD BLVD",
            "city": "RICHMOND",
            "state": "MO",
            "postal_code": "640852229",
            "telephone_number": "816-470-5432",
            "fax_number": "816-470-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAY COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "THORNBERRY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "816-470-7320"
    },
    "taxonomies": [
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "540491701",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS -UB",
            "identifier": "90052014",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010491702",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "6350600",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE HEALTHLINK",
            "identifier": "114311",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SNF",
            "identifier": "90267015",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-1500",
            "identifier": "01514018",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, MO

Sources for this page

Verify at the official NPI Registry.