THE GRAND RIVER HEALTH SYSTEM CORPORATION NPI 1003001769

Registered Nurse (Community Health) in Chillicothe, MO

About THE GRAND RIVER HEALTH SYSTEM CORPORATION

The Grand River Health System Corporation is a provider in Chillicothe, MO. The NPI number assigned to this provider is 1003001769. The practitioner's primary taxonomy code is Registered Nurse (163WC1500X). The provider is registered as an organization and their NPI record was last updated 10 years ago. The Grand River Health System Corporation operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Hedrick Medical Center Home Heath Agency.

NPI	1003001769 National Provider Indentifier (NPI) The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name	THE GRAND RIVER HEALTH SYSTEM CORPORATION
Provider Location Address	498 PARK LN CHILLICOTHE, MO 64601 Provider location address The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address	498 PARK LN CHILLICOTHE, MO 64601 Provider mailing address The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity Type	Organization Entity type code The code describing the type of health care provider that is being assigned an NPI. Codes are: 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?	N/A
Is Organization Subpart?	No What is a subpart? Subparts are the components and separate physical locations of organization health care providers. Examples include: Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization Name	HEDRICK MEDICAL CENTER HOME HEATH AGENCY Provider other organization name The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; : 5 = other.
Other Name Type	Doing Business As (3)
Enumeration Date	09-06-2007 Provider enumeration date The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date	07-15-2008 Last update date The date that a record was last updated or changed.

Primary Taxonomy

Taxonomy Code	163WC1500X Primary Taxonomy Code The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Classification	Registered Nurse
Type	Nursing Service Providers
Specialization	Community Health

Business Address

THE GRAND RIVER HEALTH SYSTEM CORPORATION
498 PARK LN
CHILLICOTHE, MO
ZIP 64601
Phone: (660) 646-2199

Map Location

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Mailing Address

THE GRAND RIVER HEALTH SYSTEM CORPORATION
498 PARK LN
CHILLICOTHE, MO
ZIP 64601
Phone: (660) 646-2199

Authorized Official

Authorized Official Name	BRIAN J JOHNSTON Authorized official name The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official Title	CEO
Authorized Official Phone	(660) 646-1480

193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Secondary Taxonomies

The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No.	Taxonomy Code	Type	Classification	Specialization	License No.	State	Primary
1	164W00000X	Nursing Service Providers	Licensed Practical Nurse				No
1	Taxonomy Description: an individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Additional Identifiers

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State
941965303	MEDICAID (05)	MO

Other Providers at the same location

The following 4 providers are registered at the same or nearby location.

NPI	Name / Type	Taxonomy	Address
1245274653	SAINT LUKES HOSPITAL OF CHILLICOTHE Organization	Hospice Care, Community Based	498 PARK LN CHILLICOTHE, MO 64601 (660) 646-2199
1366637027	THE GRAND RIVER HEALTH SYSTEM CORPORATION Organization	Homemaker	498 PARK LN CHILLICOTHE, MO 64601 (660) 646-2199
1437353687	MRS. TINA MARIE JONES P.T. Individual	Physical Therapist	498 PARK LN CHILLICOTHE, MO 64601 (660) 707-4263
1457546111	GRAND RIVER HEALTH SYSTEM CORPORATION Organization	Technician (Personal Care Attendant)	498 PARK LN CHILLICOTHE, MO 64601 (660) 646-2199

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