NPIMap

Organization Active NPI

Bates County Memorial Hospital Ambulance

  • Land Ambulance
  • Butler, MO
National Provider Identifier
1356448740
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
013005 Issued in 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
Last updated
Aug 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Authorized official

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

Specialties & licenses 1

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

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

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356448740. Details of each certification follow.

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
OtherNon-profit
Enrollment address
615 W Nursery St
Butler, MO 64730-1840
Other Hospital Practice Location
Hospital subgroups
General, Long-term, Swing-bed approved

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Bates County Memorial HospitalCCN 260034 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

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 DirectorCeo Sep 1, 2020
W-2 Managing Employee Sep 1, 2020
Operational/Managerial Control Sep 1, 2020
Linda Jennings Individual Corporate OfficerVice Chairman Apr 1, 2020
Jerry Jones Individual Corporate OfficerMember Apr 1, 2020
James Shade Individual Corporate OfficerChairman Apr 1, 2020
Bates County Memorial Hospital Organization, Butler, MO Operational/Managerial Control Mar 3, 2003
Richard R King Individual Corporate OfficerTreasurer Apr 1, 2020

Owners & managing parties with NPI records 7

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

Practitioners & affiliated clinicians

Affiliated clinicians 81

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

View all 81

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, MO

Sources for this page

Verify at the official NPI Registry.