Citizens Memorial Hospital District
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Bolivar, MO
NPI 1821970385 · NPPES record last updated Oct 15, 2025
Key facts
- NPI
- 1821970385
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- CITIZENS MEMORIAL HOSPITAL DISTRICT
- Practice address
- 1160 W Parkview St
Bolivar, MO 65613 - Phone
- (417) 328-4300
- NPI assigned
- Jul 24, 2025
- Organization subpart
- Yes
- Parent organization (as reported)
- CITIZENS MEMORIAL HOSPITAL DISTRICT
Authorized official
- Name
- Renee Marie Meyer
- Title
- Cfo
- Phone
- (417) 328-6258
Owned or controlled facilities with NPI records 19
Other NPIs with the same Medicare PAC ID 6
Member of 1
Practitioners 50
-
Marcelo Assmann, MD
-
Tracy L Beckham, CRNA
-
Travis James Bell, PA-C
-
Jason Brooks, CRNA
-
Keith Butvilas, DO
-
Ryan Mathew Clark, CRNA
-
Savannah A Clark, CRNA
-
Craig David Dunseth, M.D.
-
Cary Dawn Edwards, C.R.N.A.
-
John Gamble III, M.D.
-
Erik Josef Glassl, CRNA
-
Shawnee Kay Glenn, CRNA
-
Dmitriy Alex Grishchuk, CRNA
-
Jacob Douglas Hay, CRNA
-
Donald Edward Hockman II, D.O.
-
Jana B Horner, MD
-
Laura L Miller, CFNP
-
Kati Anne Morgan, CRNA
-
Michael John Munn, APRN
-
Vickie Renee Pence, MS,PA
Medicare Care Compare: Dialysis facility
- Listed as
- CMH Dialysis Center
- Ownership
- Non-profit
- Certified
- Jan 16, 2026
- Medicare certification status
- Active
- Dialysis stations
- 16
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D2334264 | CMH Dialysis Center | Certificate of waiver | Nov 17, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
All facility ownership & control disclosures 19
| Facility | Type | Role | Since |
|---|---|---|---|
| Citizens Memorial Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Aug 1, 1981 Aug 1, 1981 |
| Citizens Memorial Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Aug 1, 1981 Aug 1, 1981 |
| Citizens Memorial Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Aug 1, 1981 Aug 1, 1981 |
| Ellett Memorial Hospital |
Hospital | Operational/Managerial Control | Nov 1, 2013 |
| Ellett Memorial Hospital |
Hospital | Operational/Managerial Control (75%) | Jun 1, 2018 |
| Ac Rural Health Clinic |
Rural health clinic | Operational/Managerial Control (75%) | Jun 1, 2018 |
| Humansville Family Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jul 3, 1990 Jul 3, 1990 |
| Pleasant Hope Family Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Oct 14, 2000 Oct 14, 2000 |
| Butterfield Park Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Oct 1, 1991 Oct 1, 1991 |
| Dade County Family Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Dec 1, 1992 Dec 1, 1992 |
| Stockton Family Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Aug 1, 1994 Jan 1, 2007 |
| Ash Grove Family Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 1, 1994 Mar 1, 1994 |
| CMH OB/GYN and Pediatric Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 2, 2001 Mar 2, 2001 |
| Dallas County Family Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Nov 1, 1995 Nov 1, 1995 |
| Southside Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Aug 1, 2011 Aug 1, 2011 |
| Bolivar Family Care Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Oct 1, 2013 Oct 1, 2013 |
| CMH Osceola Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Nov 1, 2014 Nov 1, 2014 |
| CMH El Dorado Springs Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 3, 2017 Jan 3, 2017 |
| CMH Willard Medical Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Dec 6, 2021 Dec 6, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251016004087 | MO | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 2769574433 | Practice locations: Bolivar, MO |
National Provider Directory
- Part of
- James L Molchan MD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
1160 W Parkview St
Bolivar, MO 65613
Mailing address
1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone (417) 328-6709
Other names
- CMH Dialysis Center
Other providers in Bolivar, MO
- Citizens Memorial Hospital District
- Citizens Memorial Hospital District
- Citizens Memorial Hospital District
- Citizens Memorial Hospital District
- Citizens Memorial Hospital District
- Citizens Memorial Hospital District
- Citizens Memorial Hospital District
- Rachel Lynn Clark
- Ryan Mathew Clark
- CMH Foot and Ankle Clinic
All providers in Bolivar, MO · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2025. 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.