SULLIVAN COUNTY MEMORIAL HOSPITAL
NPI 1063553642
Emergency Medicine in Milan, MO
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 2 active CLIA laboratory certificates and lists Amy Michael, Chief Financial Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Sullivan County Memorial Hospital is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
20Medicare enrollment records show 20 clinicians reassign Medicare billing to Sullivan County Memorial Hospital, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 6 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 8
Clinicians, nearest first (20)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 2
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 Compliance 26D0441688
Sullivan County Memorial Hospital · Milan, MOCertificate of Waiver 26D0441684
Sullivan County Memorial Hospital Milan Family Practice · Milan, MOFrequently 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.
Is Sullivan County Memorial Hospital enrolled in Medicare?
Yes. Sullivan County Memorial Hospital is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Sullivan County Memorial Hospital?
According to the CMS Revalidation Reassignment List (October 2026 release), 20 clinicians in 8 Medicare specialties reassign their Medicare billing to Sullivan County Memorial Hospital. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (9), Family Practice (5) and Cardiovascular Disease (Cardiology) (1). Of these, 4 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Sullivan County Memorial Hospital hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Sullivan County Memorial Hospital accept?
Health plans from 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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Sullivan County Memorial Hospital · NPI 1063553642
Emergency Medicine organization in Milan, Missouri. Organization record, active in the CMS NPPES registry since February 8, 2007.
## Identity
- **NPI:** 1063553642 (Entity type: Organization)
- **Enumerated:** February 8, 2007
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **Organization subpart:** No
- **Authorized official:** Amy Michael, CHIEF FINANCIAL OFFICER
## Practice location
- **Address:** 630 W 3RD ST, Milan, MO 63556-1076
- **Phone:** (660) 265-4212 · **Fax:** (660) 265-4898
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 20 clinicians in 8 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (9), Family Practice (5), Cardiovascular Disease (Cardiology) (1); 4 practice at this address and 6 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 16, 2011
- **Other identifiers:** Medicare ID-Type Unspecified 000050097; Medicaid 540324803 (MO)
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1063553642) · Data from the CMS NPPES public registry.