NPIMap

Organization Active NPI

General John J Pershing Memorial Hospital

Doing business as Pershing Memorial Hospital

  • Certified Registered Nurse Anesthetist
  • Brookfield, MO
National Provider Identifier
1689811929
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
19843 Issued in MO
Legal business name
GENERAL JOHN J PERSHING MEMORIAL HOSPITAL
Doing business as
Pershing Memorial Hospital
Practice address
130 E Lockling St
Brookfield, MO 64628-2337
Phone
(660) 258-2222
Fax
(660) 258-5668
NPI assigned
Jan 8, 2009
Last updated
Nov 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Authorized official

Name
Mr. Kenneth E Baranski, CPA
Title
Cfo
Phone
(660) 258-1288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 19843 MO Primary

Addresses

Primary practice location

130 E Lockling St
Brookfield, MO 64628-2337

Mailing address

130 E Lockling St
Brookfield, MO 64628-2337
Phone (660) 258-2222

Other identifiers 1

IdentifierTypeStateIssuer
912858305MedicaidMO

Other names 1

  • Pershing Memorial Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
General John J Pershing8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1689811929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E LOCKLING ST",
            "city": "BROOKFIELD",
            "state": "MO",
            "postal_code": "646282337",
            "telephone_number": "660-258-2222",
            "fax_number": "660-258-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E LOCKLING ST",
            "city": "BROOKFIELD",
            "state": "MO",
            "postal_code": "646282337",
            "telephone_number": "660-258-2222",
            "fax_number": "660-258-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL JOHN J PERSHING MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "BARANSKI",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "660-258-1288",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "19843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "912858305",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pershing Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pershing Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.