Basic Information
| Provider Information | |||||||||
| NPI: | 1669687125 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COX-MONETT HOSPITAL, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | COX MONETT HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 E HIGHWAY 60 | ||||||||
| Address2: | |||||||||
| City: | MONETT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 657088258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4172353144 | ||||||||
| FaxNumber: | 4173541412 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 E HIGHWAY 60 | ||||||||
| Address2: | |||||||||
| City: | MONETT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 657088258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4172353144 | ||||||||
| FaxNumber: | 4173541412 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2007 | ||||||||
| LastUpdateDate: | 12/08/2021 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | BASS | ||||||||
| AuthorizedOfficialFirstName: | DARREN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT / CEO | ||||||||
| AuthorizedOfficialTelephone: | 4173541407 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 12/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207P00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 244717104 | 05 | MO | MEDICAID |