NPIMap

Organization Active NPI

Citizens Memorial Hospital District

  • Emergency Medicine Physician
  • Bolivar, MO
National Provider Identifier
1558548818
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CITIZENS MEMORIAL HOSPITAL DISTRICT
Practice address
1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone
(417) 326-6000
NPI assigned
Jan 29, 2008
Last updated
Oct 15, 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 15, 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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Certified Registered Nurse Anesthetist 367500000X
Anesthesiology Physician 207L00000X
Emergency Medicine Physician 207P00000X Primary
Diagnostic Radiology Physician 2085R0202X

Addresses

Primary practice location

1500 N Oakland Ave
Bolivar, MO 65613-3011

Mailing address

1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone (417) 326-6000

Other identifiers 1

IdentifierTypeStateIssuer
541752507MedicaidMO

Other names 1

  • CMH Hospital-Based Physicians Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070827000044 MO Part B Supplier - Clinic/Group Practice 2769574433 Receives reassigned benefits from 132 practitioners
1 other NPI on this enrollment
Practice locations: Bolivar, MO
O20240322001010 FL Part B Supplier - Clinic/Group Practice 2769574433 Receives reassigned benefits from 1 practitioner
Practice locations: Naples, FL

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Citizens Memorial Hosp Dist

Member organizations 16

Organizations listed as members of this organization in the National Provider Directory.

View all 16

Locations

1500 N Oakland Ave
Ste 135
Bolivar, MO 65613

708 N Pomme de Terre Ave
Ave
Bolivar, MO 65613
Phone (417) 777-4800

525 Branson Landing Blvd
Ste 307
Branson, MO 65616
Phone (417) 335-7736

800 State Highway 248
Ste 2E
Branson, MO 65616

309 E Hospital Rd
El Dorado Springs, MO 64744
Phone (417) 876-4645

Ownership & related parties

All facility ownership & control disclosures 19

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

FacilityTypeRoleSince
Citizens Memorial HospitalBolivar, MO, CCN 260195 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 1981
Aug 1, 1981
Citizens Memorial HospitalBolivar, MO, CCN 26S195 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 1981
Aug 1, 1981
Citizens Memorial HospitalBolivar, MO, CCN 26U195 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 1981
Aug 1, 1981
Ellett Memorial HospitalAppleton City, MO, CCN 261301 Hospital Operational/Managerial Control Nov 1, 2013
Ellett Memorial HospitalAppleton City, MO, CCN 26Z301 Hospital Operational/Managerial Control (75%) Jun 1, 2018
Ac Rural Health ClinicAppleton City, MO, CCN 268593 Rural health clinic Operational/Managerial Control (75%) Jun 1, 2018
Humansville Family Medical CenterHumansville, MO, CCN 263976 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 3, 1990
Jul 3, 1990
Pleasant Hope Family Medical CenterPleasant Hope, MO, CCN 268552 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 14, 2000
Oct 14, 2000
Butterfield Park Medical CenterBolivar, MO, CCN 268553 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 1991
Oct 1, 1991
Dade County Family Medical CenterGreenfield, MO, CCN 263411 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Dec 1, 1992
Dec 1, 1992
Stockton Family Medical CenterStockton, MO, CCN 263977 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Aug 1, 1994
Jan 1, 2007
Ash Grove Family Medical CenterAsh Grove, MO, CCN 263471 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 1, 1994
Mar 1, 1994
CMH OB/GYN and Pediatric ClinicBolivar, MO, CCN 268554 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 2, 2001
Mar 2, 2001
Dallas County Family Medical CenterBuffalo, MO, CCN 263482 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 1, 1995
Nov 1, 1995
Southside Medical CenterBolivar, MO, CCN 268668 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 2011
Aug 1, 2011
Bolivar Family Care CenterBolivar, MO, CCN 268694 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2013
Oct 1, 2013
CMH Osceola Medical CenterOsceola, MO, CCN 268727 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 1, 2014
Nov 1, 2014
CMH El Dorado Springs Medical CenterEl Dorado Springs, MO, CCN 268751 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 3, 2017
Jan 3, 2017
CMH Willard Medical CenterWillard, MO, CCN 268791 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 6, 2021
Dec 6, 2021

Owned or controlled facilities with NPI records 19

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

  • Citizens Memorial Healthcare

    dba Bolivar Family Care Center

    • Rural Health Clinic/Center
    • Bolivar, MO
    • NPI 1063588960

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Southside Medical Center

    • Rural Health Clinic/Center
    • Bolivar, MO
    • NPI 1407141153

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Ash Grove Family Medical Center

    • Rural Health Clinic/Center
    • Ash Grove, MO
    • NPI 1417161449

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Stockton Family Medical Center

    • Rural Health Clinic/Center
    • Stockton, MO
    • NPI 1447464227

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Humansville Family Medical Center

    • Rural Health Clinic/Center
    • Humansville, MO
    • NPI 1508070269

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba CMH Willard Medical Center

    • Rural Health Clinic/Center
    • Willard, MO
    • NPI 1568127397

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba CMH Osceola Medical Center

    • Rural Health Clinic/Center
    • Osceola, MO
    • NPI 1578961454

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Dallas County Family Medical Center

    • Rural Health Clinic/Center
    • Buffalo, MO
    • NPI 1609080571

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Dade County Family Medical Center

    • Rural Health Clinic/Center
    • Greenfield, MO
    • NPI 1699989350

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Pleasant Hope Family Medical Center

    • Rural Health Clinic/Center
    • Pleasant Hope, MO
    • NPI 1740494541

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba Butterfield Park Medical Center

    • Rural Health Clinic/Center
    • Bolivar, MO
    • NPI 1831303502

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Citizens Memorial Healthcare

    dba CMH El Dorado Springs Medical Center

    • Rural Health Clinic/Center
    • El Dorado Springs, MO
    • NPI 1851834659

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
View all 19

Practitioners & affiliated clinicians

Practitioners 136

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 136

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1558548818",
    "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",
            "telephone_number": "417-326-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-326-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITIZENS MEMORIAL HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITIZENS MEMORIAL HOSPITAL DISTRICT",
        "enumeration_date": "2008-01-29",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "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": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "541752507",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMH Hospital-Based Physicians",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bolivar, MO

Sources for this page

Verify at the official NPI Registry.