NPIMap

Organization Active NPI

John Fitzgibbon Memorial Hospital, Inc

Doing business as Fitzgibbon Hospitalist Group

  • Hospitalist Physician
  • Marshall, MO
National Provider Identifier
1801917539
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
JOHN FITZGIBBON MEMORIAL HOSPITAL, INC
Doing business as
Fitzgibbon Hospitalist Group
Practice address
2305 S 65 Highway
Marshall, MO 65340-3702
Phone
(660) 886-7431
Fax
(660) 886-9001
NPI assigned
Apr 2, 2007
Last updated
Mar 5, 2024By the provider in NPPES
Organization subpart
No

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) 831-3759

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

2305 S 65 Highway
Marshall, MO 65340-3702

Mailing address

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

Other names 1

  • Fitzgibbon Hospitalist Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Grandriver Medical Clin9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

2301 S Highway 65
Marshall, MO 65340
Phone (660) 831-5001

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1801917539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 S 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 S 65 HIGHWAY",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "653403702",
            "telephone_number": "660-886-7431",
            "fax_number": "660-886-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN FITZGIBBON MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "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": "660-831-3759"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fitzgibbon Hospitalist Group",
            "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.