MOSAIC MEDICAL CENTER - MARYVILLE (NPI# 1568936995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1568936995 |
Entity Type | Organization |
Organization Name | MOSAIC MEDICAL CENTER - MARYVILLE |
Other Organization Name | MOSAIC SKILLED NURSING - 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 | 275N00000X | Medicare Defined Swing Bed Unit | Hospital Units |
Other Name | Type Code |
---|---|
Mosaic Skilled Nursing - 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 |
1477027803 | Mosaic Medical Center - Maryville | Psychiatric 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 |
1477027803 | Mosaic Medical Center - Maryville | Psychiatric 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 | 275N00000X |
Grouping | Hospital Units |
Classification | Medicare Defined Swing Bed Unit |
A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
Notes: Source: Code of Federal Regulations #42, Section 482.66. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316062789 | Ssm Regional Health Services | Medicare Defined Swing Bed Unit | 2016 S Main St, Maryville, MO 64468-2655 | 2007-03-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013054212 | Ste Genevieve County Memorial Hospital | Medicare Defined Swing Bed Unit | 800 Sainte Genevieve Dr, Ste Genevieve, MO 63670-1434 | 2007-01-30 |
1104801547 | Barton County Memorial Hospital | Medicare Defined Swing Bed Unit | 29 Nw 1st Ln, Lamar, MO 64759-8105 | 2005-12-08 |
1245220052 | Ray County Memorial Hospital | Medicare Defined Swing Bed Unit | 904 Wollard Blvd, Richmond, MO 64085-2229 | 2005-10-24 |
1083601330 | Western Missouri Medical Center | Medicare Defined Swing Bed Unit | 403 Burkarth Rd, Warrensburg, MO 64093 | 2005-10-03 |
1407469778 | Noble Health Fulton Inc. | Medicare Defined Swing Bed Unit | 10 S Hospital Dr, Fulton, MO 65251-2510 | 2020-08-26 |
1558985911 | Poplar Bluff Regional Medical Center LLC | Medicare Defined Swing Bed Unit | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2020-06-02 |
1861861726 | Southeast Health Center of Reynolds LLC | Medicare Defined Swing Bed Unit | 100 Highway 21 N, Ellington, MO 63638-9409 | 2015-09-22 |
1023487162 | Southeast Health Center of Ripley County | Medicare Defined Swing Bed Unit | 109 Plum St, Doniphan, MO 63935-1277 | 2015-09-18 |
1093194888 | Southeast Health Center of Ripley County | Medicare Defined Swing Bed Unit | 109 Plum St, Doniphan, MO 63935-1277 | 2015-05-26 |
1053707562 | Parkland Health Center - Weber Road | Medicare Defined Swing Bed Unit | 1212 Weber Rd, Farmington, MO 63640-3325 | 2015-04-10 |
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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.