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Bates County Memorial Hospital Ambulance

Organization Active NPI Land Ambulance · Butler, MO

NPI 1356448740 · NPPES record last updated Aug 15, 2023

Key facts

NPI
1356448740
Entity type
Organization (NPI type 2)
Primary specialty
Land Ambulance 3416L0300X
License
013005 (MO)
Legal business name
BATES COUNTY MEMORIAL HOSPITAL AMBULANCE
Practice address
615 W Nursery St
Butler, MO 64730-1840
Phone
(660) 200-7000
Fax
(660) 200-7015
NPI assigned
Sep 20, 2006
Organization subpart
No

Authorized official

Name
Gregory Weaver
Title
Ceo
Phone
(660) 200-7000

Owners & managing parties with NPI records 7

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

Other NPIs on the same Medicare enrollment 1

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

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

Affiliated clinicians 81

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

View all 81

Medicare Care Compare: Hospital

Listed as
Bates County Memorial Hospital CCN 260034
Overall star rating
★★★☆☆ 3 of 5
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Hospital certification: CCN 260034

Legal name
BATES COUNTY MEMORIAL HOSPITAL
Doing business as
BATES COUNTY MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 27, 2024
Beds
60
Ownership / control type
Local
Organization structure
Other · Non-profit
Enrollment address
615 W Nursery St
Butler, MO 64730-1840
Other Hospital Practice Location
Hospital subgroups
General, Long-term, Swing-bed approved

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Gregory a Weaver
Individual 		Corporate Director
Ceo		 Sep 1, 2020
W-2 Managing Employee Sep 1, 2020
Operational/Managerial Control Sep 1, 2020
Linda Jennings
Individual 		Corporate Officer
Vice Chairman		 Apr 1, 2020
Jerry Jones
Individual 		Corporate Officer
Member		 Apr 1, 2020
James Shade
Individual 		Corporate Officer
Chairman		 Apr 1, 2020
Bates County Memorial Hospital
Organization · Butler, MO 		Operational/Managerial Control Mar 3, 2003
Richard R King
Individual 		Corporate Officer
Treasurer		 Apr 1, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20030327000012 MO Part a Provider - Hospital 8123937356 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Butler, MO

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 013005 MO Yes

Addresses

Primary practice location

615 W Nursery St
Butler, MO 64730-1840

Mailing address

PO Box 19793
Belfast, ME 04915-4092
Phone (660) 200-7000

Other identifiers

IdentifierTypeStateIssuer
013005OtherMOSTATE OF MISSOURI
800673618MedicaidMO

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 15, 2023.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1356448740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19793",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154092",
            "telephone_number": "660-200-7000",
            "fax_number": "660-200-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W NURSERY ST",
            "city": "BUTLER",
            "state": "MO",
            "postal_code": "647301840",
            "telephone_number": "660-200-7000",
            "fax_number": "660-200-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BATES COUNTY MEMORIAL HOSPITAL AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "660-200-7000"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MO",
            "license": "013005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MISSOURI",
            "identifier": "013005",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800673618",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, MO

All providers in Butler, MO · Land Ambulance in Missouri

Sources for this page

Verify at the official NPI Registry.