NPIMap

Organization Active NPI

Moberly Hospital Company LLC

Doing business as Moberly Regional Medical Center

  • Psychiatric Hospital Unit
  • Moberly, MO
National Provider Identifier
1366413882
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
423-9 Issued in MO
Legal business name
MOBERLY HOSPITAL COMPANY LLC
Doing business as
Moberly Regional Medical Center
Practice address
1515 Union Ave
Moberly, MO 65270-9407
Phone
(660) 263-8400
NPI assigned
Feb 1, 2006
Last updated
Apr 16, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MOBERLY HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Authorized official

Name
Paula M Lalor
Title
Director/Delegated Official
Phone
(629) 215-3953

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 423-9 MO Primary

Addresses

Primary practice location

1515 Union Ave
Moberly, MO 65270-9407

Mailing address

PO Box 60856
Saint Louis, MO 63160-0856

Other names 1

  • Moberly Regional Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080404000724 MO Part A Provider - Hospital 9436052230 Practice locations: Moberly, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366413882. Details of each certification follow.

Hospital certification: CCN 26S074

Legal name
MOBERLY HOSPITAL COMPANY LLC
Doing business as
MOBERLY REGIONAL MEDICAL CENTER
Organization structure
LLCProprietary
Incorporated
Oct 29, 2007 in DE
Enrollment address
1515 Union Ave
Moberly, MO 65270-9407
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Moberly Regional Med Ce6 organizations share this tax ID, including this one
Part of
Moberly Regional Med Ce

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Kevin J Hammons Individual Corporate OfficerPresident/Board Member Feb 27, 2012
Corporate DirectorPresident/Board Member Jan 1, 2020
Nathaniel K Summar Individual Corporate DirectorVP Revenue Management Jul 15, 2017
Justin D Pitt Individual Corporate OfficerExec VP/Assist Sec/Board Member Mar 1, 2022
Corporate DirectorExec VP/Assist Sec/Board Member Mar 1, 2022
William Bradley Cash Individual Corporate OfficerExec VP Jun 1, 2018
Community Health Systems Inc Organization, Franklin, TN Corporation 5% Or Greater Indirect Ownership Interest Dec 31, 2007 100%
Jason Kevin Johnson Individual Corporate OfficerSenior VP Jan 6, 2020
Michael D Hall Individual W-2 Managing EmployeeCeo Jun 25, 2022
Roman Gabriel Ottinger Individual Corporate OfficerSenior VP/Treasurer Jan 6, 2020
Paula M Lalor Individual Corporate DirectorDirector/Delegated Official Apr 1, 2017
Edna S Buffington-Price Individual Corporate DirectorVP/Authorized Official Mar 1, 2022
Community Health Investment Company LLC Organization, Franklin, TN LLC 5% Or Greater Direct Ownership Interest Dec 31, 2007 100%
Christopher G Cobb Individual Corporate OfficerVP/Secretary Apr 1, 2017
CHS Community Health Systems Inc Organization, Franklin, TN Corporation, Chain home office 5% Or Greater Indirect Ownership Interest Dec 31, 2007 100%

Facilities with the same owner 120

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 120

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1366413882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60856",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631600856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 UNION AVE",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652709407",
            "telephone_number": "660-263-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBERLY HOSPITAL COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOBERLY HOSPITAL, INC.",
        "enumeration_date": "2006-02-01",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "629-215-3953"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "MO",
            "license": "423-9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moberly Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moberly Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moberly, MO

Sources for this page

Verify at the official NPI Registry.