NPIMap

Organization Active NPI

Pemiscot County Memorial Hospital

Doing business as Pemiscot County Nursing Home

  • Nursing Facility/Intermediate Care Facility
  • Hayti, MO
National Provider Identifier
1861594004
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
PEMISCOT COUNTY MEMORIAL HOSPITAL
Doing business as
Pemiscot County Nursing Home
Practice address
946 E Reed St
Hayti, MO 63851-1243
Phone
(573) 359-3612
Fax
(573) 359-3398
NPI assigned
Sep 1, 2006
Last updated
Nov 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Authorized official

Name
Kerry Noble
Title
Ceo
Phone
(573) 359-3612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X MO Primary

Addresses

Primary practice location

946 E Reed St
Hayti, MO 63851-1243

Mailing address

946 E Reed St
P O Box 489
Hayti, MO 63851-1243
Phone (573) 359-3612

Other identifiers 1

IdentifierTypeStateIssuer
101493104MedicaidMO

Other names 1

  • Pemiscot County Nursing Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
W O Bryant MD12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1861594004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "946 E REED ST",
            "address_2": "P O BOX 489",
            "city": "HAYTI",
            "state": "MO",
            "postal_code": "638511243",
            "telephone_number": "573-359-3612",
            "fax_number": "573-359-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "946 E REED ST",
            "city": "HAYTI",
            "state": "MO",
            "postal_code": "638511243",
            "telephone_number": "573-359-3612",
            "fax_number": "573-359-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEMISCOT COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "NOBLE",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-359-3612"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101493104",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pemiscot County Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hayti, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.