CROSS TRAILS MEDICAL CENTER


Address: 408 S Broadview St, Cape Girardeau, MO 63703-5725
Phone: 5733320808

CROSS TRAILS MEDICAL CENTER (NPI# 1356393268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356393268
Entity Type Organization
Organization Name CROSS TRAILS MEDICAL CENTER
Practice Address 408 S Broadview St
Cape Girardeau
MO 63703-5725
Practice Telephone 5733320808
Practice Fax Number 5733397945
Mailing Telephone 5733320808
Mailing Fax Number 5733397945
Enumeration Date 2006-05-17
Last Update Date 2008-06-26
Authorized Official Name VICKI A SMITH (CEO)
Authorized Official Telephone 5733391196
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MO 508082807 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1225191752 Cross Trails Medical Center Clinic/Center 307 Gabriel St., Advance, MO 63730 2006-12-18
1962565499 Cross Trails Medical Center Clinic/Center 109 Hwy 51 North, Marble Hill, MO 63764 2006-12-18
1972925444 Cross Trails Medical Center Dentist 1314 Brenda Ave, Perryville, MO 63775-2624 2014-01-17
1215368402 Cross Trails Medical Center Clinic/Center 1314 Brenda Ave, Perryville, MO 63775-2624 2013-12-12
1841508264 Cross Trails Medical Center Dentist 307 Gabriel St, Advance, MO 63730 2010-09-20
1811051642 Cross Trails Medical Center Clinic/Center 408 S Broadview St, Cape Girardeau, MO 63703-5725 2006-12-19
1821151622 Cross Trails Medical Center Clinic/Center 109 Hwy 51 North, Marble Hill, MO 63764 2006-12-19

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities CROSS TRAILS MEDICAL CENTER 408 S Broadview St, Cape Girardeau, MO 63703-5725

Office Location

Street Address 408 S BROADVIEW ST
City CAPE GIRARDEAU
State MO
Zip Code 63703-5725

Providers in the same location

NPI Name Taxonomy Address Enumeration
1316948730 Susan B Farrow Nurse Practitioner 408 S Broadview St, Cape Girardeau, MO 63703-5725 2005-08-09
1114563798 Tracey D Cooley Dental Hygienist 408 S Broadview St, Cape Girardeau, MO 63703-5725 2019-11-19
1386108181 Constance R Koerner-bean Social Worker 408 S Broadview St, Cape Girardeau, MO 63703-5725 2019-01-25
1356839971 Andrew J Bova Dentist 408 S Broadview St, Cape Girardeau, MO 63703-5725 2018-04-30
1447754122 Katie Kristine Berghoff Dental Hygienist 408 S Broadview St, Cape Girardeau, MO 63703-5725 2018-03-19
1104348507 Mitra Nejat-bina Dentist 408 S Broadview St, Cape Girardeau, MO 63703-5725 2017-07-07
1609295674 Autumn Rose Vangennip Dental Hygienist 408 S Broadview St, Cape Girardeau, MO 63703-5725 2014-04-07
1205178274 Nancy K Johnson Nurse Practitioner 408 S Broadview St, Cape Girardeau, MO 63703-5725 2013-03-18
1083964563 Ashley Lipke Registered Nurse 408 S Broadview St, Cape Girardeau, MO 63703-5725 2012-09-12
1669746624 Alan David Jones Dentist 408 S Broadview St, Cape Girardeau, MO 63703-5725 2012-03-07
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1720566102 Christian Torres Diaz Dentist 3070 William Street, Cape Girardeau, MO 63703 2018-07-30
1457758153 Broadway Ltc, LLC Pharmacy 37 Doctors Park Ste 7, Cape Girardeau, MO 63703 2014-11-24
1336562263 Rachel Speer Community Health Worker 20 South Sprigg St, Cape Girardeau, MO 63703 2014-01-29
1245653120 Mary Wilburn Community Health Worker 20 S Spigg, Cape Girardeau, MO 63703 2014-01-28
1831523695 Saint Francis Medical Center General Acute Care Hospital 150 South Mount Auburn Road, Suite 342, Cape Girardeau, MO 63703 2013-08-29
1033481163 J K Essmyer Medical Services LLC Clinic/Center 300 Mt Auburn Rd, Auburn Surgery Center, Inc, Cape Girardeau, MO 63703 2012-02-06
1477867844 Drx - East Missouri Providers, P.C. Family Medicine 465 S Mount Auburn Road, Suite 103, Cape Girardeau, MO 63703 2010-07-28
1346564879 Richard William Tobey Family Medicine 3250 Gordonville Rd Ste 301, Cape Girardeau, MO 63703 2010-03-26
1144413568 Stephanie Danette Miller Family Medicine 817 S. Mount Auburn, Suite 100, Southeast Primary Care, Cape Gerardeau, MO 63703 2007-08-20
1437349305 Shanaree Mae Muzinich Radiology 70 Doctor's Park, Cape Girardeau, MO 63703 2007-07-27
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

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1912505041 Northwest Health Services Inc Clinic/Center 10500 State Route T, Savannah, MO 64485-2456 2020-10-12
1407469570 Family Care Health Centers Clinic/Center 2717 Sidney Street, St. Louis, MO 63104 2020-08-28
1407478399 Big Springs Medical Association Clinic/Center 2879 James Blvd, Poplar Bluff, MO 63901-3395 2020-05-13
1295356731 Health Care Coalition of Lafayette County Clinic/Center 811 S Business Highway 13, Lexington, MO 64067-1515 2020-05-06
1376164699 East Central Missouri Behavioral Health Services, Inc Clinic/Center 896 S Sturgeon St, Montgomery City, MO 63361-2716 2020-04-27
1750912044 Northwest Health Services, Inc. Clinic/Center 418 E 2nd St, Maryville, MO 64468-1703 2020-01-27
1669003950 Northwest Health Services, Inc. Clinic/Center 525 W South Hills Dr, Maryville, MO 64468-3653 2020-01-27
1063052553 Compass Health, Inc. Clinic/Center 1319 E Highway 24 Ste B, Moberly, MO 65270-3682 2020-01-13
1407490741 Advocates for A Healthy Community Inc Clinic/Center 2238 W Kingsley St, Springfield, MO 65807-5456 2019-10-30
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Competitor

Search similar providers

City CAPE GIRARDEAU
Zip Code 63703

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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