NPIMap

Organization Active NPI

Ste Genevieve County Memorial Hospital

Doing business as Bloomsdale Imaging Center

  • Radiology Clinic/Center
  • Bloomsdale, MO
National Provider Identifier
1902153539
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
STE GENEVIEVE COUNTY MEMORIAL HOSPITAL
Doing business as
Bloomsdale Imaging Center
Bloomsdale Rehab
Practice address
255 Boderman
Suite 1C
Bloomsdale, MO 63627
Phone
(573) 883-4473
Fax
(573) 883-4472
NPI assigned
Aug 14, 2012
Last updated
Sep 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Authorized official

Name
Scott Griffin
Title
Revenue Cycle Director
Phone
(573) 883-2751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X NU Primary

Addresses

Primary practice location

255 Boderman
Suite 1C
Bloomsdale, MO 63627

Mailing address

800 Ste Genevieve Dr
Ste Genevieve, MO 63670-1434
Phone (573) 883-2751

Other identifiers 1

IdentifierTypeStateIssuer
010491801MedicaidMO

Other names 2

  • Bloomsdale Imaging Center Doing business as
  • Bloomsdale Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040102000645 MO Part B Supplier - Clinic/Group Practice 3274432802 Receives reassigned benefits from 66 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bloomsdale, MO; Ste Genevieve, MO

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
St Genevieve Med Hosp17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Member organizations 1

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

Locations

255 Boderman
Ste 1C
Bloomsdale, MO 63627
Phone (573) 883-4473

Practitioners & affiliated clinicians

Practitioners 12

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": "1344902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789084800000",
    "number": "1902153539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 STE GENEVIEVE DR",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636701434",
            "telephone_number": "573-883-2751",
            "fax_number": "573-883-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 BODERMAN",
            "address_2": "SUITE 1C",
            "city": "BLOOMSDALE",
            "state": "MO",
            "postal_code": "63627",
            "telephone_number": "573-883-4473",
            "fax_number": "573-883-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STE GENEVIEVE COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-14",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "573-883-2751"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010491801",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bloomsdale Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bloomsdale Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomsdale, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.