NPIMap

Organization Active NPI

Freeman Neosho Hospital

  • Critical Access Hospital
  • Neosho, MO
National Provider Identifier
1841307428
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
FREEMAN NEOSHO HOSPITAL
Practice address
113 W Hickory St
Neosho, MO 64850-1705
Phone
(417) 451-1234
Fax
(417) 347-0702
NPI assigned
Aug 23, 2006
Last updated
Oct 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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

Authorized official

Name
Steven W Graddy
Title
Cfo
Phone
(417) 347-6678

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X NU Primary

Addresses

Primary practice location

113 W Hickory St
Neosho, MO 64850-1705

Mailing address

1102 W 32ND St
Joplin, MO 64804-3503
Phone (417) 347-1111

Other identifiers 3

IdentifierTypeStateIssuer
241760OtherHEALTHLINK
32066OtherBLUE CHOICE
540323805MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040730000757 MO Part B Supplier - Clinic/Group Practice 4284624552 Receives reassigned benefits from 55 practitioners
Practice locations: Neosho, MO

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
Tax ID family
Jeffery a Wool MD5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Freeman Neosho Physician GroupNeosho, MO, CCN 268722 Rural health clinic Operational/Managerial Control (100%) Feb 1, 2014
Freeman Clinic of AndersonAnderson, MO, CCN 268773 Rural health clinic Operational/Managerial Control (100%) Jul 1, 2018

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 56

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.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1841307428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 W 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043503",
            "telephone_number": "417-347-1111",
            "fax_number": "417-347-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W HICKORY ST",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648501705",
            "telephone_number": "417-451-1234",
            "fax_number": "417-347-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEMAN NEOSHO HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "GRADDY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "417-347-6678"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "241760",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "32066",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "540323805",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neosho, MO

Sources for this page

Verify at the official NPI Registry.