NPIMap

Organization Active NPI

John Fitzgibbon Memorial Hospital, Inc.

  • Clinic/Center
  • Marshall, MO
National Provider Identifier
1780077065
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
JOHN FITZGIBBON MEMORIAL HOSPITAL, INC.
Practice address
2305 South 65 Highway
Marshall, MO 65340-3702
Phone
(660) 886-8414
Fax
(660) 831-3340
NPI assigned
Mar 11, 2015
Organization subpart
Yes
Parent organization
JOHN FITZGIBBON MEMORIAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Nancy Harris
Title
Cfo/Coo
Phone
(660) 886-7431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2305 South 65 Highway
Marshall, MO 65340-3702

Mailing address

2305 South 65 Highway
Marshall, MO 65340-3702
Phone (660) 886-7431

Other names 1

  • Fitzgibbon Outpatient Clinics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080708000234 MO Part B Supplier - Clinic/Group Practice 2567351570 Receives reassigned benefits from 16 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fayette, MO; Marshall, MO

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Marshall Surgical Assoc9 organizations share this tax ID, including this one
Part of
Marshall Surgical Assoc

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1780077065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 SOUTH 65 HIGHWAY",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "653403702",
            "telephone_number": "660-886-7431",
            "fax_number": "660-886-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 SOUTH 65 HIGHWAY",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "653403702",
            "telephone_number": "660-886-8414",
            "fax_number": "660-831-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN FITZGIBBON MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHN FITZGIBBON MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2015-03-11",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "CFO/COO",
        "authorized_official_telephone_number": "660-886-7431"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fitzgibbon Outpatient Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marshall, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.