NPIMap

Organization Active NPI

Washington County Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Potosi, MO
National Provider Identifier
1821140724
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
224 Issued in MO
Legal business name
WASHINGTON COUNTY MEMORIAL HOSPITAL
Practice address
300 Health Way Dr
Potosi, MO 63664-1420
Phone
(573) 438-5451
Fax
(573) 438-2399
NPI assigned
Jan 18, 2007
Last updated
Aug 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Authorized official

Name
Debra Pratt
Title
Cfo
Phone
(573) 438-5451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 224 MO Primary

Addresses

Primary practice location

300 Health Way Dr
Potosi, MO 63664-1420

Mailing address

300 Health Way Dr
Potosi, MO 63664-1420
Phone (573) 438-5451

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111103000418 MO Part A Provider - Critical Access Hospital 3476456880 Practice locations: Potosi, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821140724. Details of each certification follow.

Hospital certification: CCN 26Z308

Legal name
WASHINGTON COUNTY MEMORIAL HOSPITAL
Doing business as
WASHINGTON COUNTY MEMORIAL HOSPITAL
Organization structure
GovernmentNon-profit
Enrollment address
300 Health Way Dr
Potosi, MO 63664-1420

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Washington County Memorial Hospital Organization, Potosi, MO Other Dec 1, 1963 100%
Melvin a Warden Individual Corporate DirectorCounty Hospital Board Chairman Apr 1, 1995
Debra a Pratt Individual W-2 Managing EmployeeCeo Nov 28, 2016

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Washington County Memorial HospitalPotosi, MO, CCN 261308 Hospital Other (100%) Dec 1, 1963
Austin Plaza Primary CarePotosi, MO, CCN 268505 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jun 1, 2001
Jun 1, 2001
Healthway Primary CarePotosi, MO, CCN 263410 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jun 1, 2001
Jun 1, 2001
WCMH Urgent Care ClinicPotosi, MO, CCN 268650 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2009
Potosi Rural Health ClinicPotosi, MO, CCN 268651 Rural health clinic Operational/Managerial Control Aug 30, 2010

Owned or controlled facilities with NPI records 5

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

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598486400000",
    "number": "1821140724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HEALTH WAY DR",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636641420",
            "telephone_number": "573-438-5451",
            "fax_number": "573-438-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEALTH WAY DR",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636641420",
            "telephone_number": "573-438-5451",
            "fax_number": "573-438-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-438-5451"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MO",
            "license": "224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potosi, MO

Sources for this page

Verify at the official NPI Registry.