HANNIBAL MOBILE DIAGNOSTICS, LLC (NPI# 1417016114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417016114 |
Entity Type | Organization |
Organization Name | HANNIBAL MOBILE DIAGNOSTICS, LLC |
Practice Address |
2910 St. Mary's Ave. Hannibal MO 63401 |
Practice Telephone | 5732217870 |
Practice Fax Number | 5732219323 |
Mailing Telephone | 5732217870 |
Mailing Fax Number | 5732219323 |
Enumeration Date | 2006-12-08 |
Last Update Date | 2020-08-22 |
Authorized Official Name | BRANDON SELLE (ADMINISTRATOR) |
Authorized Official Telephone | 5732217870 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | ========= | MO | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | RAILROAD MEDICARE | P00126139 | 01 |
Street Address |
2910 ST. MARY'S AVE. |
City | HANNIBAL |
State | MO |
Zip Code | 63401 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255981064 | Amanda Lynn Jennings | Nurse Practitioner | Hannibal Clinic, 100 Medical Drive, Hannibal, MO 63401 | 2019-09-13 |
1316452295 | Hannibal Regional Healthcare System, Inc | Hospice Care, Community Based | 6401 Hwy Mm, Hannibal, MO 63401 | 2017-12-13 |
1932614351 | Sidney M Johnson | Counselor | 1221 Broadway St, Hannibal, MO 63401 | 2017-12-07 |
1316467210 | Jessica Baker | Counselor | 4355 Paris Gravel Road, Hannibal, MO 63401 | 2017-06-21 |
1346787066 | Hands Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17 Settlerstrail, Hannibal, MO 63401 | 2017-01-20 |
1134571672 | Pamela Barrigar | Social Worker | 4600 Mcmasters Ave, Hannibal, MO 63401 | 2016-07-08 |
1639540677 | Jessica Murfin | Speech-Language Pathologist | 544 N Veterans Rd, Hannibal, MO 63401 | 2015-10-16 |
1366835639 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 8965 Highway 36 Ste 3, Hannibal, MO 63401 | 2015-03-11 |
1639324254 | Hannibal Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 118 Steam Boat Bend, Hannibal, MO 63401 | 2008-11-24 |
1780856112 | Barbara Belle Smith | Social Worker | 3700 Hwy Mm, Hannibal, MO 63401 | 2008-03-26 |
Find all providers in zip 63401 |
Taxonomy Code | 335V00000X |
Grouping | Suppliers |
Classification | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. |
Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: title and definition modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952946378 | Mjm Diagnostics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1301 Oak St Ste 713, Kansas City, MO 64106-2913 | 2019-11-08 |
1861986176 | Biomedical Imaging LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3450 Bridgeland Dr Ste F, Bridgeton, MO 63044-2605 | 2018-06-20 |
1508225715 | Missouri Diagnostic Services, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1517 Copper Rd, Holts Summit, MO 65043-2033 | 2016-02-16 |
1891125142 | Midwest Mobile Imaging | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 408 Washington Ave Ste 107, West Plains, MO 65775-3404 | 2013-11-23 |
1265786305 | Prowave Diagnostics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 238 Peach Ln, Ridgedale, MO 65739-4182 | 2012-10-27 |
1720239767 | American Mobile X-ray, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 221 Adair Road, Branson, MO 65615-7865 | 2008-10-08 |
1528214913 | Innovative Mobile Services LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 202 Miller Way, Monett, MO 65708-8336 | 2008-08-18 |
1790959773 | Digital X Mobile, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 13 Cedar Crest Dr, Fenton, MO 63026-5041 | 2008-04-21 |
1376749812 | Mobile X-ray Services LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3050 N 20th St, Ozark, MO 65721-5925 | 2007-06-22 |
1720106958 | Gateway Sonographics, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1115 James Dr, Imperial, MO 63052-2343 | 2007-03-26 |
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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.