NPIMap

Organization Active NPI

Cedar County Memorial Hospital

  • Critical Access Hospital
  • El Dorado Springs, MO
National Provider Identifier
1619090404
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
CEDAR COUNTY MEMORIAL HOSPITAL
Practice address
1401 S Park St
El Dorado Springs, MO 64744-2037
Phone
(417) 876-2511
Fax
(417) 876-3812
NPI assigned
Apr 9, 2007
Last updated
Apr 2, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CEDAR COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Authorized official

Name
Donald L Carpenter
Title
Ceo
Phone
(417) 876-2511

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

1401 S Park St
El Dorado Springs, MO 64744-2037

Mailing address

1401 S Park St
El Dorado Springs, MO 64744-2037
Phone (417) 876-2511

Other names 1

  • Professional Group Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120000314 MO Part B Supplier - Clinic/Group Practice 7315841129 Receives reassigned benefits from 55 practitioners
1 other NPI on this enrollment
Practice locations: El Dorado Springs, MO; Stockton, MO

Other NPIs with the same Medicare PAC ID 4

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
Cedar County Memorial Hospital

Locations

1600 E Evergreen St
Ste C
Cameron, MO 64429
Phone (816) 632-2139

326 S Mount Auburn Rd
Cape Girardeau, MO 63703

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Cedar County Memorial HospitalEl Dorado Springs, MO, CCN 261323 Hospital Operational/Managerial Control (100%) Dec 31, 1991
Cedar County Memorial HospitalEl Dorado Springs, MO, CCN 26Z323 Hospital Operational/Managerial Control (100%) Dec 31, 1991
CCMH Medical Mall ClinicEl Dorado Springs, MO, CCN 263474 Rural health clinic Operational/Managerial Control (100%) Oct 30, 1995

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 59

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 59

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1619090404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S PARK ST",
            "city": "EL DORADO SPRINGS",
            "state": "MO",
            "postal_code": "647442037",
            "telephone_number": "417-876-2511",
            "fax_number": "417-876-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S PARK ST",
            "city": "EL DORADO SPRINGS",
            "state": "MO",
            "postal_code": "647442037",
            "telephone_number": "417-876-2511",
            "fax_number": "417-876-3812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CEDAR COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2007-04-09",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-876-2511"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in El Dorado Springs, MO

Sources for this page

Verify at the official NPI Registry.