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Citizens Memorial Healthcare

Organization Active NPI Rural Health Clinic/Center · Stockton, MO

NPI 1447464227 · NPPES record last updated Oct 21, 2025

Key facts

NPI
1447464227
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
CITIZENS MEMORIAL HEALTHCARE
Practice address
1521 3Rd Rd
Stockton, MO 65785-9608
Phone
(417) 276-5131
NPI assigned
May 10, 2007
Organization subpart
Yes
Parent organization (as reported)
CITIZENS MEMORIAL HOSPITAL DISTRICT

Authorized official

Name
Renee Marie Meyer
Title
Cfo
Phone
(417) 328-6258

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 with the same Medicare PAC ID 13

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

Corporate family (same tax ID) 18

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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

Facilities with the same owner 18

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

Practitioners 144

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 144

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Rural health clinic certification: CCN 263977

Legal name
CITIZENS MEMORIAL HEALTHCARE
Doing business as
STOCKTON FAMILY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 3, 1990
Last certification
Dec 2, 2024
Ownership / control type
2B
Organization structure
Other · Non-profit
Enrollment address
1521 3Rd Rd
Stockton, MO 65785-9608
Related CCNs
260195

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Corey Rich
Individual 		Corporate Director Nov 21, 2017 100%
Robin R Sechler
Individual 		Corporate Director
Board of Director		 Dec 20, 2011
Michael Calhoun
Individual 		Corporate Officer
Ceo		 Jan 1, 2022
W-2 Managing Employee
Ceo		 Jan 1, 2022
Citizens Memorial Hospital District
Organization · Bolivar, MO
Created for acquisition 		5% Or Greater Direct Ownership Interest Aug 1, 1994 100%
Operational/Managerial Control Jan 1, 2007
Harold D Berry
Individual 		Corporate Director
Board of Director		 Mar 20, 2012
John Kallenbach
Individual 		Corporate Officer
Board Member		 Jul 17, 2018
Janieca Lynn Hancock
Individual 		Corporate Officer
Board Member		 Apr 18, 2023
Renee M Meyer
Individual 		W-2 Managing Employee
Cfo		 Jan 1, 2020
Kerry P Douglas
Individual 		Corporate Director
Board of Director-Chairman		 Apr 5, 2011

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080125000568 MO Part a Provider - Rural Health Clinic 4183528169 Practice locations: Stockton, MO

National Provider Directory

Tax ID family
Citizens Memorial Healthcare (19 organizations share this tax ID)
Part of
James L Molchan MD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

1521 3Rd Rd
Stockton, MO 65785-9608

Mailing address

1500 N Oakland Ave
Bolivar, MO 65613-3011

Other names

  • Stockton Family Medical Center Doing business as

Other providers in Stockton, MO

All providers in Stockton, MO · Rural Health Clinic/Center in Missouri

Sources for this page

Verify at the official NPI Registry.