NPIMap

Organization Active NPI

Citizens Memorial Healthcare

Doing business as Humansville Family Medical Center

  • Rural Health Clinic/Center
  • Humansville, MO
National Provider Identifier
1508070269
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CITIZENS MEMORIAL HEALTHCARE
Doing business as
Humansville Family Medical Center
Practice address
201 S Arthur St
Humansville, MO 65674-8400
Phone
(417) 754-2223
Fax
(417) 754-8046
NPI assigned
May 10, 2007
Last updated
Oct 21, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CITIZENS MEMORIAL HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

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

Specialties & licenses 2

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

Addresses

Primary practice location

201 S Arthur St
Humansville, MO 65674-8400

Mailing address

1500 N Oakland Ave
Bolivar, MO 65613-3011

Other names 1

  • Humansville Family 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
O20080123000715 MO Part A Provider - Rural Health Clinic 4183528169 Practice locations: Humansville, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508070269. Details of each certification follow.

Rural health clinic certification: CCN 263976

Legal name
CITIZENS MEMORIAL HEALTHCARE
Doing business as
HUMANSVILLE FAMILY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 3, 1990
Last certification
Dec 3, 2024
Ownership / control type
2B
Organization structure
OtherNon-profit
Enrollment address
201 S Arthur St
Humansville, MO 65674-8400
Related CCNs
260195

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

Other NPIs with the same Medicare PAC ID 13

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

View all 13

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
26D0675153Humansville Family Medical Center201 S Arthur, Humansville, MO 65674ComplianceFeb 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
Citizens Memorial Healthcare19 organizations share this tax ID, including this one
Part of
Citizens Memorial District

Other organizations with this tax ID 18

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

View all 18

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 8

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
Robin R Sechler Individual Corporate DirectorBoard of Director Dec 20, 2011
Citizens Memorial Hospital District Organization, Bolivar, MO Non-profit 5% Or Greater Direct Ownership Interest Jul 3, 1990 100%
Operational/Managerial Control Jul 3, 1990 100%
Harold D Berry Individual Corporate DirectorBoard of Director Mar 20, 2012
John Kallenbach Individual Corporate Director Jul 17, 2018
Janieca Lynn Hancock Individual Corporate DirectorBoard Member Apr 18, 2023
Renee M Meyer Individual Corporate OfficerCfo/Officer Jan 1, 2020 100%
W-2 Managing EmployeeCfo/Officer Jan 1, 2020 100%
Kerry P Douglas Individual Corporate DirectorBoard of Director-Secretary Apr 5, 2011

Owners & managing parties with NPI records 7

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

Facilities with the same owner 18

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

View all 18

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1508070269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S ARTHUR ST",
            "city": "HUMANSVILLE",
            "state": "MO",
            "postal_code": "656748400",
            "telephone_number": "417-754-2223",
            "fax_number": "417-754-8046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITIZENS MEMORIAL HEALTHCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITIZENS MEMORIAL HOSPITAL DISTRICT",
        "enumeration_date": "2007-05-10",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "417-328-6258"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Humansville Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Humansville, MO

Sources for this page

Verify at the official NPI Registry.