MOSAIC MEDICAL CENTER - MARYVILLE (NPI# 1477027803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1477027803 |
Entity Type | Organization |
Organization Name | MOSAIC MEDICAL CENTER - MARYVILLE |
Other Organization Name | MOSAIC BEHAVIORAL HEALTH - MARYVILLE |
Practice Address |
2016 S Main St Maryville MO 64468-2655 |
Practice Telephone | 6605622600 |
Practice Fax Number | 6605627943 |
Mailing Telephone | 6605622600 |
Mailing Fax Number | 6605627943 |
Enumeration Date | 2019-01-18 |
Last Update Date | 2019-03-12 |
Authorized Official Name | DWIGHT R CARVELL (DIRECTOR OF REIMBURSEMENT) |
Authorized Official Telephone | 8162730473 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 273R00000X | Psychiatric Unit | Hospital Units |
Other Name | Type Code |
---|---|
Mosaic Behavioral Health - Maryville | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093289431 | Mosaic Medical Center - Maryville | Family Medicine | 301 E Price Ave Ste A, Savannah, MO 64485-2482 | 2019-01-18 |
1184189797 | Mosaic Medical Center - Maryville | Internal Medicine | 2016 S Main St, Maryville, MO 64468-2655 | 2019-02-07 |
1205300498 | Mosaic Medical Center - Maryville | Family Medicine | 408 Dodge St, Bedford, IA 50833-1413 | 2019-01-22 |
1598239790 | Mosaic Medical Center - Maryville | Family Medicine | 114 E South Hills Dr, Maryville, MO 64468-2659 | 2019-01-22 |
1568936995 | Mosaic Medical Center - Maryville | Medicare Defined Swing Bed Unit | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
1265906663 | Mosaic Medical Center - Maryville | General Acute Care Hospital | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
1821562265 | Mosaic Medical Center - Maryville | Clinic/Center | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | MOSAIC MEDICAL CENTER - MARYVILLE | 2016 S Main St, Maryville, MO 64468-2655 |
Iowa Business Entities | MOSAIC MEDICAL CENTER - MARYVILLE | 2016 South Main, Maryville, MO 64468 |
Street Address |
2016 S MAIN ST |
City | MARYVILLE |
State | MO |
Zip Code | 64468-2655 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619970761 | Lorraine M Dodson | Specialist | 2016 S Main St, Maryville, MO 64468-2655 | 2005-05-23 |
1275183055 | Alison Sporleder | Family Medicine | 2016 S Main St, Maryville, MO 64468-2655 | 2019-09-13 |
1982251856 | Paula Goodridge | Family Medicine | 2016 S Main St, Maryville, MO 64468-2655 | 2019-08-24 |
1184189797 | Mosaic Medical Center - Maryville | Internal Medicine | 2016 S Main St, Maryville, MO 64468-2655 | 2019-02-07 |
1568936995 | Mosaic Medical Center - Maryville | Medicare Defined Swing Bed Unit | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
1265906663 | Mosaic Medical Center - Maryville | General Acute Care Hospital | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
1821562265 | Mosaic Medical Center - Maryville | Clinic/Center | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
1194241349 | Angela Nicole Williamson | Nurse Practitioner | 2016 S Main St, Maryville, MO 64468-2655 | 2017-08-18 |
1225577372 | Estella Myrick | Nurse Practitioner | 2016 S Main St, Maryville, MO 64468-2655 | 2017-02-21 |
1558737874 | Megan Augustine | Nurse Practitioner | 2016 S Main St, Maryville, MO 64468-2655 | 2015-08-20 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619315603 | William Sean Prescott | Counselor | 318 North Main, Maryville, MO 64468 | 2013-06-12 |
1215284617 | Janet Luzmoor | Counselor | 109 East Summit Dr, Maryville, MO 64468 | 2012-08-06 |
1629336177 | Kristi Renee White | Social Worker | 423 N Market St, Maryville, MO 64468 | 2012-05-02 |
1285942474 | Kyle William Bowers | Physical Therapist | 2016 South Main Street, Maryville, MO 64468 | 2010-09-22 |
1861600660 | Debra Anne Hopkins | Physical Therapist | 2416 South Main St, Maryville, MO 64468 | 2007-05-18 |
1023235975 | Susan Kay Grispino | Occupational Therapist | Area Cooperative for Educational Support, 1429 South Munn Avenue, Maryville, MO 64468 | 2007-04-20 |
1760542567 | North West Missouri State University | Clinic/Center | 800 University Drive, Maryville, MO 64468 | 2006-12-11 |
1528154994 | Bruce E Twaddle | Dentist | 231 Summit Drive, Maryville, MO 64468 | 2006-10-05 |
1669588075 | Stanley David Snyder | Dentist | 2825 South Main Street, Maryville, MO 64468 | 2006-08-21 |
1710906896 | Ileen Richey-arellin | Social Worker | 109 E Summit Drive, Family Guidance Center, Maryville, MO 64468 | 2006-07-19 |
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Taxonomy Code | 273R00000X |
Grouping | Hospital Units |
Classification | Psychiatric Unit |
In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154447563 | Ssm Regional Health Services | Psychiatric Unit | 2016 S Main St, Maryville, MO 64468-2655 | 2007-03-21 |
1790747160 | Blount Memorial Hospital, Inc. | Psychiatric Unit | 907 E Lamar Alexander Pkwy, Maryville, TN 37804-5015 | 2006-04-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033499256 | University of Missori Health System | Psychiatric Unit | Dept of Medicine Univ of Missouri, One Hospital Drive Ne402, Columbia, MO 65212-0001 | 2011-08-18 |
1629391636 | Farmington Missouri Hospital Company, LLC | Psychiatric Unit | 1212 Weber St., Farmington, MO 63640-3325 | 2010-03-04 |
1346312873 | Phelps County Regional Medical Center | Psychiatric Unit | 1000 West 1oth Street, Rolla, MO 65401 | 2006-11-13 |
1700831724 | Poplar Bluff Regional Medical Center LLC | Psychiatric Unit | 3100 Oak Grove Rd., Poplar Bluff, MO 63901 | 2006-05-24 |
1912989351 | Cass Medical Center | Psychiatric Unit | 1800 E Mechanic St, Harrisonville, MO 64701-2017 | 2005-11-18 |
1124012356 | Columbia Regional Hospital - Psychiatric Unit | Psychiatric Unit | 404 Keene St, Columbia, MO 65201-6626 | 2005-09-02 |
1023017746 | St Alexius Hospital Corporation 1 | Psychiatric Unit | 3933 S Broadway, Saint Louis, MO 63118-4601 | 2005-07-14 |
1427661792 | Noble Health Fulton Inc. | Psychiatric Unit | 10 S Hospital Dr, Fulton, MO 65251-2510 | 2020-08-26 |
1376031757 | Prime Healthcare Services - Kansas City LLC | Psychiatric Unit | 1000 Carondelet Dr, Kansas City, MO 64114-4673 | 2018-05-01 |
1528516192 | Western Missouri Medical Center | Psychiatric Unit | 403 Burkarth Rd, Warrensburg, MO 64093 | 2016-09-13 |
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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.