Cedar County Memorial Hospital

Organization Active NPI Critical Access Hospital · El Dorado Springs, MO

NPI 1619090404 · NPPES record last updated Apr 2, 2026

Key facts

NPI
1619090404
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 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
Organization subpart
Yes
Parent organization (as reported)
CEDAR COUNTY MEMORIAL HOSPITAL

Authorized official

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

Owned or controlled facilities with NPI records 3

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

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 4

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

Practitioners 59

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

View all 59

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

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

Medicare enrollment records

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

National Provider Directory

Part of
Cedar County Family Clinic

Locations

326 S Mount Auburn Rd
Cape Girardeau, MO 63703

Specialties & licenses

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

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 identifiers

IdentifierTypeStateIssuer
540325305MedicaidMO

Other names

  • Professional Group Other name

Other providers in El Dorado Springs, MO

All providers in El Dorado Springs, MO · Critical Access Hospital in Missouri

Sources for this page

Verify at the official NPI Registry.