NPIMap

Organization Active NPI

Freeman Neosho Hospital

  • Rural Health Clinic/Center
  • Anderson, MO
National Provider Identifier
1437513686
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FREEMAN NEOSHO HOSPITAL
Practice address
510 Park St
Anderson, MO 64831-9280
Phone
(417) 845-0545
Fax
(417) 845-0548
NPI assigned
Apr 13, 2016
Last updated
Apr 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Authorized official

Name
Steven W Graddy
Title
Cfo
Phone
(417) 347-6678

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

510 Park St
Anderson, MO 64831-9280

Mailing address

1102 W 32ND St
Joplin, MO 64804-3503
Phone (417) 347-1111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180802002883 MO Part A Provider - Rural Health Clinic 4284624552 Practice locations: Anderson, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437513686. Details of each certification follow.

Rural health clinic certification: CCN 268773

Legal name
FREEMAN NEOSHO HOSPITAL
Doing business as
FREEMAN CLINIC OF ANDERSON
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 10, 2019
Last certification
Sep 10, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
510 Park St
Anderson, MO 64831-9280
Related CCNs
260137

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).

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
26D1016578Freeman Clinic of Anderson510 Park Street, Anderson, MO 64831Certificate of waiverSep 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
Jeffery a Wool MD5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

336 S Jefferson St
Neosho, MO 64850
Phone (417) 451-4200

346 S Wood St
Neosho, MO 64850
Phone (417) 455-0907

Ownership & related parties

All disclosed owners & managing parties 28

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

NameRoleSinceShare
Leesa Apfelbaum Individual W-2 Managing EmployeeDirector Patient Financial Services Jun 17, 2009
Justin J Dillingham Individual Corporate Director Apr 1, 2023
Renee Denton Individual W-2 Managing EmployeeAdministrative Services Director Sep 24, 2012
Operational/Managerial ControlAdministrative Services Director Sep 24, 2012
Gary Wasson Individual Corporate Director Jan 1, 2009
Glen Brown Individual Corporate Director Apr 28, 2001
Larry McIntire Individual Corporate Director Oct 1, 2008
Rodney J McFarland Individual Corporate Director Sep 2, 1993
Jeffery Thompson Individual Corporate OfficerChief Clinical Officer Feb 15, 2021
Matthew W Fry Individual Corporate OfficerPresident and Ceo Apr 1, 2025
John M Cox Individual Corporate Director Jun 24, 2004
Steven W Graddy Individual Corporate OfficerCfo Nov 1, 2007
W-2 Managing Employee Nov 1, 2007
Rudy Farber Individual Corporate Director Oct 5, 2005
Freeman Neosho Hospital Organization, Neosho, MO Non-profit Operational/Managerial Control Jul 1, 2018 100%
James Brothers Individual Corporate Director Aug 26, 2009
James Fleischaker Individual Corporate Director Apr 1, 2007
Amanda M Harrell Individual Corporate OfficerCmo Jan 1, 2025
Jeanee Kennedy Individual Corporate Director Mar 1, 2021
Brandon Davis Individual Corporate Director Jan 1, 2005
Brady G Hesington Individual Corporate Director May 7, 2025
Mark Williams Individual Corporate Director Jan 1, 2001
Kent Farnsworth Individual Corporate Director May 7, 2025
Jason L Maxfield Individual Corporate Director May 1, 2015
Freeman-Oak Hill Health System Organization, Joplin, MO Non-profit, Chain home office Operational/Managerial Control Jul 1, 2018 100%
James Armstrong Individual Corporate Director May 7, 2025
Mitch McCumber Individual Corporate Director Oct 5, 2005
Craig L Pendergrass Individual Corporate Director May 7, 2025
Larry G Barnes Individual Corporate Director Oct 2, 2005
Lance Beshore Individual Corporate Director Aug 24, 1987

Owners & managing parties with NPI records 27

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

View all 27

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Freeman Neosho Physician GroupNeosho, MO, CCN 268722 Rural health clinic Operational/Managerial Control (100%) Feb 1, 2014

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 8

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

Practitioners & affiliated clinicians

Practitioners 101

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 101

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460505600000",
    "number": "1437513686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 W 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043503",
            "telephone_number": "417-347-1111",
            "fax_number": "417-347-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 PARK ST",
            "city": "ANDERSON",
            "state": "MO",
            "postal_code": "648319280",
            "telephone_number": "417-845-0545",
            "fax_number": "417-845-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEMAN NEOSHO HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-13",
        "last_updated": "2016-04-13",
        "status": "A",
        "authorized_official_last_name": "GRADDY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "417-347-6678"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, MO

Sources for this page

Verify at the official NPI Registry.