NPIMap

Organization Active NPI

Freeman Neosho Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Neosho, MO
National Provider Identifier
1689782872
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
FREEMAN NEOSHO HOSPITAL
Practice address
113 W Hickory St
Neosho, MO 64850-1705
Phone
(417) 347-1234
Fax
(417) 347-0702
NPI assigned
Aug 28, 2006
Last updated
Oct 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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

Authorized official

Name
Mr. Steve W Graddy
Title
Cfo
Phone
(417) 347-6678

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary
Critical Access Hospital 282NC0060X

Addresses

Primary practice location

113 W Hickory St
Neosho, MO 64850-1705

Mailing address

1102 West 32ND Street
Joplin, MO 64804
Phone (417) 347-1111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080602000221 MO Part A Provider - Critical Access Hospital 4284624552 Practice locations: Neosho, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689782872. Details of each certification follow.

Hospital certification: CCN 26Z331

Legal name
FREEMAN NEOSHO HOSPITAL
Doing business as
FREEMAN NEOSHO HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Dec 28, 1993 in MO
Enrollment address
113 W Hickory St
Neosho, MO 64850-1705

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
J Larry Dowell MD5 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

113 W Hickory St
Neosho, MO 64850
Phone (417) 347-1078

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Leesa Apfelbaum Individual W-2 Managing Employee Jun 17, 2009
Renee Denton Individual W-2 Managing EmployeeDirector Admin Services Sep 24, 2012
Operational/Managerial ControlDirector Admin Services Sep 24, 2012
Gary Wasson Individual Corporate Director Jan 1, 2009
Steven W Graddy Individual Corporate OfficerCfo Nov 1, 2007
Rudy Farber Individual Corporate Director Oct 5, 2005
Kevin Gaudette Individual Corporate Director Oct 5, 2005
Paula Baker Individual Corporate DirectorPresident and Ceo Jan 1, 2012
Operational/Managerial ControlPresident and Ceo Jan 1, 2012
Freeman-Oak Hill Health System Organization, Joplin, MO Non-profit Operational/Managerial Control Jul 1, 2013
Mitch McCumber Individual Corporate Director Oct 5, 2005
Craig L Pendergrass Individual Corporate Director Oct 5, 2005
Larry G Barnes Individual Corporate Director Oct 5, 2005

Owners & managing parties with NPI records 16

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 16

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Freeman Neosho Physician GroupNeosho, MO, CCN 268722 Rural health clinic Operational/Managerial Control (100%) Feb 1, 2014
Freeman Clinic of AndersonAnderson, MO, CCN 268773 Rural health clinic Operational/Managerial Control (100%) Jul 1, 2018

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1689782872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 WEST 32ND STREET",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64804",
            "telephone_number": "417-347-1111",
            "fax_number": "417-347-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W HICKORY ST",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648501705",
            "telephone_number": "417-347-1234",
            "fax_number": "417-347-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEMAN NEOSHO HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "GRADDY",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "417-347-6678",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neosho, MO

Sources for this page

Verify at the official NPI Registry.