NPIMap

Organization Active NPI

Madison Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Fredericktown, MO
National Provider Identifier
1245305408
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MADISON MEDICAL CENTER
Practice address
611 W Main St
Fredericktown, MO 63645-1111
Phone
(573) 783-3341
Fax
(573) 783-1096
NPI assigned
Nov 22, 2006
Last updated
Sep 18, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOMEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Authorized official

Name
Lisa M Twidwell
Title
Cfo
Phone
(573) 783-3341

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

611 W Main St
Fredericktown, MO 63645-1111

Mailing address

611 W Main St
PO Box 431
Fredericktown, MO 63645-1111
Phone (573) 783-3341

Other identifiers 1

IdentifierTypeStateIssuer
621458009MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Ajay K Upadhyay MD9 organizations share this tax ID, including this one
Part of
Ajay K Upadhyay MD

Other organizations with this tax ID 8

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

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/madison-075248be

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1245305408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W MAIN ST",
            "address_2": "PO BOX 431",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "636451111",
            "telephone_number": "573-783-3341",
            "fax_number": "573-783-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W MAIN ST",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "636451111",
            "telephone_number": "573-783-3341",
            "fax_number": "573-783-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MADISON MEMORIAL HOSPITAL STOCKHOFF MEMORIAL NURSING HOME",
        "enumeration_date": "2006-11-22",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "TWIDWELL",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-783-3341"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621458009",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericktown, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; 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.