NPIMap

Organization Active NPI

Community Memorial Hospital District

Doing business as AC Rural Health Clinic

  • Family Medicine Physician
  • Appleton City, MO
National Provider Identifier
1619117256
Registry record updated Jun 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMMUNITY MEMORIAL HOSPITAL DISTRICT
Doing business as
AC Rural Health Clinic
Practice address
408 E 7TH St
Appleton City, MO 64724-1617
Phone
(660) 476-2121
NPI assigned
Feb 23, 2009
Last updated
Jun 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2026

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

Authorized official

Name
Beverly A Johnson
Title
Business Office Director
Phone
(660) 476-5203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

408 E 7TH St
Appleton City, MO 64724-1617

Mailing address

408 E 7TH St
Appleton City, MO 64724-1617
Phone (660) 476-2121

Other names 1

  • AC Rural Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000910 MO Part B Supplier - Clinic/Group Practice 0345153680 Receives reassigned benefits from 12 practitioners
4 other NPIs on this enrollment
Practice locations: Appleton City, MO

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Community Mem Hosp District5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

120 W 4th St
Appleton City, MO 64724
Phone (660) 476-2121

408 E 7th St
#97
Appleton City, MO 64724
Phone (660) 476-2121

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Ac Rural Health ClinicAppleton City, MO, CCN 268593 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 13, 2005

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780704000000",
    "number": "1619117256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E 7TH ST",
            "city": "APPLETON CITY",
            "state": "MO",
            "postal_code": "647241617",
            "telephone_number": "660-476-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 E 7TH ST",
            "city": "APPLETON CITY",
            "state": "MO",
            "postal_code": "647241617",
            "telephone_number": "660-476-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEMORIAL HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-23",
        "last_updated": "2026-06-06",
        "certification_date": "2026-06-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "660-476-5203"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AC Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton City, MO

Sources for this page

Verify at the official NPI Registry.