HANNIBAL MOBILE DIAGNOSTICS, LLC


Address: 2910 St. Mary's Ave., Hannibal, MO 63401
Phone: 5732217870

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 335V00000X Portable X-ray and/or Other Portable Diagnostic Imaging Supplier ========= MO Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
MO RAILROAD MEDICARE P00126139 01

Office Location

Street Address 2910 ST. MARY'S AVE.
City HANNIBAL
State MO
Zip Code 63401

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 335V00000X
Grouping Suppliers
Classification Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

Taxonomy Definition

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]

Providers in the same taxonomy and state

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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Competitor

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City HANNIBAL
Zip Code 63401

Improve Information

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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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