SULLIVAN COUNTY MEMORIAL HOSPITAL
NPI 1063553642
Emergency Medicine in Milan, MO

Active since February 08, 2007CLIA 26D0441684 · Waiver
630 W 3RD ST, MILAN, MO 63556(660) 265-4212(660) 265-4898 Get Directions Write a Review

NPPES record last updated: May 16, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Sullivan County Memorial Hospital NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SULLIVAN COUNTY MEMORIAL HOSPITAL (NPI 1063553642) is a healthcare organization registered as an emergency medicine in Milan, Missouri and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Amy Michael, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1063553642
Entity TypeOrganization
Primary Taxonomy207P00000X
Legal Business NameSULLIVAN COUNTY MEMORIAL HOSPITAL
Location Address630 W 3RD STMilan, MO 63556-1076
Mailing Address630 W 3rd StMilan, MO 63556-1076 · (660) 265-4212 · Fax (660) 265-4898
Fax(660) 265-4898
Organization SubpartNo
Authorized OfficialAmy MichaelChief Financial Officer · (660) 265-4212
Enumeration DateFebruary 8, 2007
Last NPPES UpdateMay 16, 2011
NPI 1063553642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License Licensed in MO · 130-49
Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

630 W 3RD ST, Milan, MO 63556

Other Identifiers 2

Medicare ID-Type Unspecified000050097
Medicaid540324803MO

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D0441684

Sullivan County Memorial Hospital Milan Family Practice · Milan, MO
Active · expires Aug 31, 2026
CLIA Number26D0441684
Laboratory TypeRural Health Clinic
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDale W. Essmyer
Laboratory Phone(660) 265-4212
Laboratory LocationSullivan County Memorial Hospital Milan Family Practice210 N Market Street, Milan, MO 63556
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner
630 W 3RD ST
MILAN, MO 63556
General Acute Care Hospital (Critical Access)
630 W 3RD ST
MILAN, MO 63556
Nurse Practitioner (Family)
630 W 3RD ST
MILAN, MO 63556
Medicare Defined Swing Bed Unit
630 W 3RD ST
MILAN, MO 63556
Clinic/Center (Rural Health)
630 W 3RD ST
MILAN, MO 63556
Family Medicine
630 W 3RD ST
MILAN, MO 63556
Nursing Facility/Intermediate Care Facility
630 W 3RD ST
MILAN, MO 63556
Family Medicine
630 W 3RD ST
MILAN, MO 63556

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sullivan County Memorial Hospital's NPI number?

The NPI number for Sullivan County Memorial Hospital is 1063553642. It was assigned to this organization in the NPPES registry on February 8, 2007.

Where is Sullivan County Memorial Hospital located?

Sullivan County Memorial Hospital is located at 630 W 3rd St, Milan, MO 63556. The listed phone number is (660) 265-4212.

What is Sullivan County Memorial Hospital's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Does Sullivan County Memorial Hospital hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0441684) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sullivan County Memorial Hospital accept?

Health plans from Anthem Blue Cross and Blue Shield and UnitedHealthcare list Sullivan County Memorial Hospital as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sullivan County Memorial Hospital was last updated on May 16, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.