Pemiscot County Memorial Hospital
Family Medicine in Kennett, MO. Organization (NPI-2).
NPI number1477091890
StatusActive
Last updated in NPPESFeb 6, 2017
Details
- NPI
- 1477091890
- Entity type
- Organization (NPI-2)
- Legal business name
- Pemiscot County Memorial Hospital
- Organization subpart
- No
- Enumeration date
- Feb 6, 2017
- Last updated
- Feb 6, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Bootheel Family Practice (Doing Business As)
Practice location
105 E Washington StKennett, MO 63857-2041
Phone 573-888-1137 · Fax 573-888-0920
Mailing address
105 E. WashingtonKennett, MO 63857
Phone 573-888-1137 · Fax 573-888-0920
Authorized official
Kerry Noble
Ceo
5733593612
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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