Bates County Memorial Hospital
Organization Active NPI General Acute Care Hospital · Butler, MO
NPI 1770536740 · NPPES record last updated Mar 17, 2021
Key facts
- NPI
- 1770536740
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- 205 45 (MO)
- Legal business name
- BATES COUNTY MEMORIAL HOSPITAL
- Practice address
- 615 W Nursery St
Butler, MO 64730-1840 - Phone
- (660) 200-7000
- Fax
- (660) 200-7004
- NPI assigned
- May 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Gregory Weaver
- Title
- Ceo
- Phone
- (660) 200-7000
Owners & managing parties with NPI records 6
Owned or controlled facilities with NPI records 5
Other NPIs on the same Medicare enrollment 8
Other NPIs with the same Medicare PAC ID 6
Related certifications (CCN) 6
Facilities with the same owner 4
Practitioners 77
-
Neil Bhargava, MD
-
Timothy Brannon, CRNA
-
Susana D'Amico, MD, FACE
-
Ryan Matthew Lustig I, M.D.
-
James L Miller, DO
-
Jonathan E. Blake, D.O.
-
Corey William Chopra, M.D.
-
William Roger Herre, M.D.
-
Terry S Lee, MD
-
Veronika McDonald, D.O.
-
Matthew Eric Nadler, M.D.
-
Milton R Wolf, MD
-
Lori King, FNP
-
Minnie J Baldridge, AUD, CCC-A
-
Jeffrey W Bissing, D.O.
-
Joseph Caresio, MD
Affiliated clinicians 81
-
Jeffrey W Bissing, D.O.
-
Daniel K Bixler, MD
-
Mark S Box, MD
-
Timothy Brannon, CRNA
-
Samuel Dean Brewster, M.D.
-
Casey Lauren Brown, APRN
-
David J Burkart, MD
-
Ellen Kay Carpenter, ANP
-
Danny K Carroll, M.D.
-
Luis F. Couchonnal, M.D.
-
Susana D'Amico, MD, FACE
-
Heather Dains, FNP-BC
-
Stacey A Dobbs, FNP
-
Kandice L. Fleming, M.D.
-
Emily Johnston, APRN
-
William Joyce Jr., D.O.
-
Lori King, FNP
Medicare Care Compare: Hospital
- Listed as
- Bates County Memorial Hospital
- Overall star rating
- ★★★☆☆ 3 of 5
- Type
- Acute Care Hospitals
- Ownership
- Government - Local
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO
Hospital certification: CCN 260034
- Legal name
- BATES COUNTY MEMORIAL HOSPITAL
- Doing business as
- BATES COUNTY MEMORIAL HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Jun 27, 2024
- Beds
- 60
- Ownership / control type
- Local
- Organization structure
- Other · Non-profit
- Enrollment address
- 615 W Nursery St
Butler, MO 64730-1840 - Hospital subgroups
- General, Long-term, Swing-bed approved
All disclosed owners & managing parties 6
| Name | Role | Since | Share |
|---|---|---|---|
| Gregory a Weaver |
Corporate Director |
Sep 1, 2020 | |
| W-2 Managing Employee | Sep 1, 2020 | ||
| Operational/Managerial Control | Sep 1, 2020 | ||
| Linda Jennings |
Corporate Officer |
Apr 1, 2020 | |
| Jerry Jones |
Corporate Officer |
Apr 1, 2020 | |
| James Shade |
Corporate Officer |
Apr 1, 2020 | |
| Bates County Memorial Hospital |
Operational/Managerial Control | Mar 3, 2003 | |
| Richard R King |
Corporate Officer |
Apr 1, 2020 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Bates County Memorial Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Sep 1, 2008 |
| Family Care Clinic Adrian |
Rural health clinic | 5% Or Greater Direct Ownership Interest | May 14, 1991 |
| Family Care Clinic High |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1990 |
| Family Care Clinic Rich Hill |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030327000012 | MO | Part a Provider - Hospital | 8123937356 |
1 other NPI on this enrollment Practice locations: Butler, MO |
| O20040121000624 | MO | Part B Supplier - Clinic/Group Practice | 8123937356 |
Receives reassigned benefits from 90 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Adrian, MO; Butler, MO; Rich Hill, MO |
National Provider Directory
Locations
619 W Nursery St
Butler, MO 64730
Phone (660) 679-6767
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 268646 | MO | |
| Clinic/Center | 261Q00000X | 268606 | MO | |
| Clinic/Center | 261Q00000X | 268639 | MO | |
| Rural Health Clinic/Center | 261QR1300X | 268606 | MO | |
| Rural Health Clinic/Center | 261QR1300X | 268646 | MO | |
| Rural Health Clinic/Center | 261QR1300X | 268639 | MO | |
| General Acute Care Hospital | 282N00000X | 205 45 | MO | Yes |
Addresses
Primary practice location
615 W Nursery St
Butler, MO 64730-1840
Mailing address
PO Box 19793
Belfast, ME 04915-4092
Phone (660) 200-7000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 540673605 | Medicaid | MO | |
| 00125012 | Other | MO | KC BC/BS |
| 010673606 | Medicaid | MO | |
| 90012015 | Other | MO | KC BC/BS |
| 0927601 | Other | MO | KC BC/BS |
| 588185306 | Medicaid | MO | |
| 800673618 | Medicaid | MO | |
| 8030343401 | Medicaid | KS |
Other providers in Butler, MO
- Bates County Memorial Hospital
- Bates County Memorial Hospital
- Bates County Memorial Hospital
- Bates County Memorial Hospital
- Bates County Memorial Hospital
- Bates County Memorial Hospital
- Bates County Memorial Hospital Ambulance
- Bates County Memorial Hospital Pharmacy
- Michelle R. Bearce
- Jeffrey W Bissing
All providers in Butler, MO · General Acute Care Hospital in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.