John Fitzgibbon Memorial Hospital, Inc.
Organization Active NPI Chiropractor · Slater, MO
NPI 1780131771 · NPPES record last updated Mar 5, 2024
Key facts
- NPI
- 1780131771
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 27-57 (MO)
- Legal business name
- JOHN FITZGIBBON MEMORIAL HOSPITAL, INC.
- Practice address
- 209 Main St
Slater, MO 65349-1411 - Phone
- (660) 529-2251
- Fax
- (660) 831-3348
- NPI assigned
- Sep 7, 2016
- Organization subpart
- No
Authorized official
- Name
- Nancy Harris
- Title
- Cfo/Coo
- Phone
- (660) 886-7431
Other NPIs on the same Medicare enrollment 14
Corporate family (same tax ID) 8
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040315000980 | MO | Part B Supplier - Clinic/Group Practice | 2567351570 |
Receives reassigned benefits from 68 practitioners 14 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Marshall, MO; Pilot Grove, MO |
National Provider Directory
- Tax ID family
- Marshall Surgical Assoc
Locations
2305 S Highway 65
Bldg A
Marshall, MO 65340
Phone (660) 886-7800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 27-57 | MO | Yes |
Addresses
Primary practice location
209 Main St
Slater, MO 65349-1411
Mailing address
2305 South 65 Highway Building a
Marshall, MO 65340-3702
Phone (660) 831-3743
Other names
- Fitzgibbon Chiropractic
Other providers in Slater, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2024. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.