NPIMap

Organization Active NPI

Bates County Memorial Hospital

Doing business as BCMH Surgical Care Clinic

  • Surgery Physician
  • Butler, MO
National Provider Identifier
1740311471
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2000165893 Issued in MO
Legal business name
BATES COUNTY MEMORIAL HOSPITAL
Doing business as
BCMH Surgical Care Clinic
Practice address
615 W Nursery St
Butler, MO 64730-1840
Phone
(660) 200-7000
Fax
(660) 200-7015
NPI assigned
Mar 7, 2007
Last updated
Aug 15, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
BATES COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Authorized official

Name
Greg A Weaver
Title
Ceo
Phone
(660) 200-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2000165893 MO Primary

Addresses

Primary practice location

615 W Nursery St
Butler, MO 64730-1840

Mailing address

615 W Nursery St
Butler, MO 64730-1840
Phone (660) 200-7000

Other identifiers 2

IdentifierTypeStateIssuer
37710014OtherMOBLUE CROSS BLUE SHIELD
540673605MedicaidMO

Other names 1

  • BCMH Surgical Care Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121000624 MO Part B Supplier - Clinic/Group Practice 8123937356 Receives reassigned benefits from 90 practitioners
7 other NPIs on this enrollment
Practice locations: Adrian, MO; Butler, MO; Rich Hill, MO

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Part of
Primary Care Specialist

Ownership & related parties

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Bates County Memorial HospitalButler, MO, CCN 260034 Hospital Operational/Managerial Control Mar 3, 2003
Bates County Memorial HospitalButler, MO, CCN 26U034 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2008
Family Care Clinic AdrianAdrian, MO, CCN 268667 Rural health clinic 5% Or Greater Direct Ownership Interest May 14, 1991
Family Care Clinic HighButler, MO, CCN 268646 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1990
Family Care Clinic Rich HillRich Hill, MO, CCN 268749 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2016

Owned or controlled facilities with NPI records 6

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

Practitioners & affiliated clinicians

Practitioners 91

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 91

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1740311471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W NURSERY ST",
            "city": "BUTLER",
            "state": "MO",
            "postal_code": "647301840",
            "telephone_number": "660-200-7000",
            "fax_number": "660-200-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W NURSERY ST",
            "city": "BUTLER",
            "state": "MO",
            "postal_code": "647301840",
            "telephone_number": "660-200-7000",
            "fax_number": "660-200-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BATES COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BATES COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2007-03-07",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "660-200-7000"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2000165893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "37710014",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "540673605",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BCMH Surgical Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BCMH Surgical Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Butler, MO

Sources for this page

Verify at the official NPI Registry.