| Ste Genevieve County Memorial Hospital | |
|
753 Pointe Basse Dr Ste Genevieve MO 63670-1820 | |
| (573) 883-2782 | |
| Not Available |
| Full Name | Ste Genevieve County Memorial Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 753 Pointe Basse Dr, Ste Genevieve, Missouri |
| Authorized Official Name and Position | Amanda Wolk (BUSINESS OFFICE DIRECTOR) |
| Authorized Official Contact | 5738837703 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ste Genevieve County Memorial Hospital Po Box 366 Ste Genevieve MO 63670-0366 Ph: (573) 883-2782 | Ste Genevieve County Memorial Hospital 753 Pointe Basse Dr Ste Genevieve MO 63670-1820 Ph: (573) 883-2782 |
| NPI Number | 1801817416 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 01/13/2023 |
| Medicare PECOS PAC ID | 3274432802 |
|---|---|
| Medicare Enrollment ID | O20040617000089 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801817416 | NPI | - | NPPES |
| CC8331 | Other | MO | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Missouri) | Primary |
| Provider Name | Dale Kraenzle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437200649 PECOS PAC ID: 3779470901 Enrollment ID: I20040302001330 |
| Provider Name | Dan H Frissell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407829849 PECOS PAC ID: 8022093780 Enrollment ID: I20040618000828 |
| Provider Name | Srinivasan Raghavan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265444608 PECOS PAC ID: 5799760450 Enrollment ID: I20040618000865 |
| Provider Name | Gary R Goldstein |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1952392110 PECOS PAC ID: 6901870815 Enrollment ID: I20040825000470 |
| Provider Name | Justin W Roberts |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1619057064 PECOS PAC ID: 9436101524 Enrollment ID: I20050217000090 |
| Provider Name | Naman A Ghazal Albar |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1639144785 PECOS PAC ID: 7113970559 Enrollment ID: I20050225000549 |
| Provider Name | Matthew S Bosner |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922088749 PECOS PAC ID: 8325082225 Enrollment ID: I20050613000213 |
| Provider Name | Gail L Craft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043361264 PECOS PAC ID: 0749217032 Enrollment ID: I20050719000339 |
| Provider Name | Holly A Huelskamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336229202 PECOS PAC ID: 7911922216 Enrollment ID: I20051005001202 |
| Provider Name | Chandra B Dommaraju |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1255361135 PECOS PAC ID: 7315963741 Enrollment ID: I20051017000191 |
| Provider Name | Susan M Odonnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720051162 PECOS PAC ID: 3678675170 Enrollment ID: I20070302000014 |
| Provider Name | Casey L Stahlheber |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497950265 PECOS PAC ID: 4486754900 Enrollment ID: I20070713000117 |
| Provider Name | Srinivas Chilakamarri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265539878 PECOS PAC ID: 3577632835 Enrollment ID: I20080513000574 |
| Provider Name | Joann Uding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518089564 PECOS PAC ID: 6002974979 Enrollment ID: I20081021000631 |
| Provider Name | Briccio S Cadiz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932182722 PECOS PAC ID: 2264598648 Enrollment ID: I20090310000449 |
| Provider Name | Mary A Mccullough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396896510 PECOS PAC ID: 5092866434 Enrollment ID: I20090625000365 |
| Provider Name | Susan L Swope |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346276094 PECOS PAC ID: 7012062623 Enrollment ID: I20090903000431 |
| Provider Name | Solomon Noguera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275516858 PECOS PAC ID: 2365424397 Enrollment ID: I20100729000596 |
| Provider Name | Sandra S Hoffmann |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1477565893 PECOS PAC ID: 4981772233 Enrollment ID: I20100817001706 |
| Provider Name | Alan D Brook |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1316938863 PECOS PAC ID: 8628102225 Enrollment ID: I20100818000753 |
| Provider Name | Michael Jeffrey Barkoviak |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1609867142 PECOS PAC ID: 4486620325 Enrollment ID: I20100823000439 |
| Provider Name | Mary E Crecelius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841272861 PECOS PAC ID: 6406036508 Enrollment ID: I20110207000742 |
| Provider Name | Kelly A Donze |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1154636579 PECOS PAC ID: 4587833165 Enrollment ID: I20110816000838 |
| Provider Name | Naeem Aslam |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750347902 PECOS PAC ID: 6002720349 Enrollment ID: I20120524000123 |
| Provider Name | Chad Ronholm |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1306027909 PECOS PAC ID: 3678739307 Enrollment ID: I20120725000481 |
| Provider Name | Kimberly L Browne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710239496 PECOS PAC ID: 7618120684 Enrollment ID: I20121227000369 |
| Provider Name | Lacey E Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174951503 PECOS PAC ID: 5395973697 Enrollment ID: I20140113001307 |
| Provider Name | Ann M Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174933667 PECOS PAC ID: 6608090691 Enrollment ID: I20140613000264 |
| Provider Name | Regine E Politte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063813046 PECOS PAC ID: 2466673223 Enrollment ID: I20141020001092 |
| Provider Name | Anne K Wolk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639562028 PECOS PAC ID: 8820318785 Enrollment ID: I20150518001731 |
| Provider Name | Jared R Arnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053703488 PECOS PAC ID: 0345541389 Enrollment ID: I20151217000458 |
| Provider Name | Melissa A Naeger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538616362 PECOS PAC ID: 0042590424 Enrollment ID: I20161130001108 |
| Provider Name | Zaki H Chowdhury |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366456022 PECOS PAC ID: 1456345669 Enrollment ID: I20161216000111 |
| Provider Name | Christina Marie Peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851767149 PECOS PAC ID: 5294042925 Enrollment ID: I20170815002537 |
| Provider Name | John Westley Pipkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346797305 PECOS PAC ID: 2163795097 Enrollment ID: I20170829000901 |
| Provider Name | Jessica M Levin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952898348 PECOS PAC ID: 0446514871 Enrollment ID: I20180510000804 |
| Provider Name | Erika Leung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326453721 PECOS PAC ID: 0345542106 Enrollment ID: I20180710003037 |
| Provider Name | Cristella Torres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609243013 PECOS PAC ID: 5193061117 Enrollment ID: I20190112000284 |
| Provider Name | Jennifer J. Becker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194221200 PECOS PAC ID: 5890033591 Enrollment ID: I20190205000280 |
| Provider Name | Samuel Mearl Medaris |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1720159346 PECOS PAC ID: 5092861435 Enrollment ID: I20200123002871 |
| Provider Name | Nicole L Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134605850 PECOS PAC ID: 2062842537 Enrollment ID: I20200423002866 |
| Provider Name | Kelly R Grein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407455421 PECOS PAC ID: 2860803467 Enrollment ID: I20201203001991 |
| Provider Name | Thomas M Castilaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588147623 PECOS PAC ID: 3476884446 Enrollment ID: I20210201002062 |
| Provider Name | Morgan Ritter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316529951 PECOS PAC ID: 7517362320 Enrollment ID: I20210817002353 |
| Provider Name | Robert D Bohnert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174293559 PECOS PAC ID: 3870984958 Enrollment ID: I20211228001105 |
| Provider Name | Aswin R Kansakar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467975573 PECOS PAC ID: 8022439660 Enrollment ID: I20220502000427 |
| Provider Name | Elizabeth M Ley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699416610 PECOS PAC ID: 9537549936 Enrollment ID: I20220701000539 |
| Provider Name | Katie Odom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194462010 PECOS PAC ID: 1658753124 Enrollment ID: I20220729002687 |
| Provider Name | Deniane John |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881256014 PECOS PAC ID: 4981933439 Enrollment ID: I20220929000876 |
| Provider Name | Hunter Elijah Wadlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073236097 PECOS PAC ID: 1254701477 Enrollment ID: I20230105000389 |
| Provider Name | Stephanie R Moll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588374698 PECOS PAC ID: 1658744313 Enrollment ID: I20230227002949 |
| Provider Name | Rebecca J Dalton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619675766 PECOS PAC ID: 5597130674 Enrollment ID: I20230403000622 |
| Provider Name | Preston Thomas Holifield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982397436 PECOS PAC ID: 7517326192 Enrollment ID: I20230629001269 |
| Provider Name | Laura M Selby |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295847606 PECOS PAC ID: 3173520830 Enrollment ID: I20230718002876 |
| Provider Name | Abigail Fischer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861146557 PECOS PAC ID: 1052772563 Enrollment ID: I20230801000749 |
| Provider Name | Sarah Mariah Peth Bohnert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245857036 PECOS PAC ID: 0446673503 Enrollment ID: I20230913002899 |
| Provider Name | Azra Niaz |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1992155105 PECOS PAC ID: 8527390079 Enrollment ID: I20231209000237 |
| Provider Name | Jesse B Garwood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265925010 PECOS PAC ID: 1951657113 Enrollment ID: I20240326002765 |
| Provider Name | Alison Griffith |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295501534 PECOS PAC ID: 9436590106 Enrollment ID: I20240513000658 |
| Provider Name | Jason C Zweig |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1982068359 PECOS PAC ID: 1355611898 Enrollment ID: I20240906002867 |
Ste Genevieve County Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 Plaza Dr, Ste Genevieve, MO 63670 Phone: 573-883-1199 Fax: 573-883-1189 | |
Ste Genevieve County Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Ste Genevieve Dr, Ste Genevieve, MO 63670 Phone: 573-883-4473 Fax: 573-883-4472 | |
Ste Genevieve County Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 753 Pointe Basse Dr, Ste Genevieve, MO 63670 Phone: 573-883-2782 Fax: 573-883-3681 | |
Ste Genevieve County Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 590 Pine Dr, Ste Genevieve, MO 63670 Phone: 573-883-4455 Fax: 573-883-4472 |