NPIMap

Organization Active NPI

Hannibal Regional Healthcare System, Inc.

Doing business as Complete Family Medicine

  • Non-Pharmacy Dispensing Site
  • Chillicothe, MO
National Provider Identifier
1508642265
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC.
Doing business as
Complete Family Medicine
Practice address
245 S Washington St
Chillicothe, MO 64601-3031
Phone
(660) 752-9006
Fax
(660) 258-9006
NPI assigned
Sep 7, 2023
Last updated
Sep 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Rob Gasaway
Title
Vice President of Finance
Phone
(573) 406-1608

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NU Primary

Addresses

Primary practice location

245 S Washington St
Chillicothe, MO 64601-3031

Mailing address

6500 Hospital Dr
Hannibal, MO 63401-6890

Other names 1

  • Complete Family Medicine Doing business as

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
26D2282496Complete Family Medicine Chillicothe245 Washington St, Chillicothe, MO 64601Certificate of waiverMay 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Hannibal Regional Healt33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

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

View all 32

Locations

245 S Washington St
Chillicothe, MO 64601
Phone (660) 752-9006

NPI Registry JSON

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1508642265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S WASHINGTON ST",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "646013031",
            "telephone_number": "660-752-9006",
            "fax_number": "660-258-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "GASAWAY",
        "authorized_official_first_name": "ROB",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "573-406-1608"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chillicothe, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.