MOBILIS HEALTH, LLC (NPI# 1750757415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750757415 |
| Entity Type | Organization |
| Organization Name | MOBILIS HEALTH, LLC |
| Practice Address |
4240 Duncan Ave Second Floor Saint Louis MO 63110-1123 |
| Practice Telephone | 3144096968 |
| Mailing Telephone | 3144096968 |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-08-18 |
| Authorized Official Name | CYRIL C WOODROME (PRESIDENT) |
| Authorized Official Telephone | 3144096968 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| Street Address |
4240 DUNCAN AVE SECOND FLOOR |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437108842 | Biotech X-ray Inc | Physiological Laboratory | 1065 Executive Parkway Dr Ste 220, Saint Louis, MO 63141-6367 | 2006-05-10 |
| 1710971080 | Specialized Imaging Services, Inc. | Physiological Laboratory | 9785 Mackenzie Rd, Suite 101, Saint Louis, MO 63123-5438 | 2005-09-01 |
| 1912387762 | Gm South, LLC | Physiological Laboratory | 12152 Tesson Ferry Rd, Saint Louis, MO 63128-1726 | 2015-06-08 |
| 1205123387 | Comprehensive Cardiovascular Consultants, Inc. | Physiological Laboratory | 3760 S Lindbergh Blvd, Suite 101, Saint Louis, MO 63127-1374 | 2011-07-08 |
| 1790921088 | Biotech X-ray, Inc. | Physiological Laboratory | 1065 Executive Parkway Dr Ste 220, Saint Louis, MO 63141-6367 | 2008-12-17 |
| 1952482531 | National Diagnostics Inc | Physiological Laboratory | 763 S New Ballas Rd, Suite 260, Saint Louis, MO 63141-8704 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760855043 | Midwest Mobile Imaging | Physiological Laboratory | 408 Washington Ave Ste 130, West Plains, MO 65775-3404 | 2015-11-09 |
| 1184026098 | Braincare, LLC | Physiological Laboratory | 303 N Stadium Blvd, Ste 249, Columbia, MO 65203-1493 | 2014-09-23 |
| 1043539190 | Home Oximetry and Sleep Testing of Missouri | Physiological Laboratory | 1720 Kansas Ave, Kansas City, MO 64127-2628 | 2010-05-27 |
| 1730134784 | Nitelife LLC | Physiological Laboratory | 100 Sarah Ann Blvd, Troy, MO 63379-2038 | 2006-05-24 |
| 1235194002 | Sleep Kwest, LLC | Physiological Laboratory | 101b Progress Pkwy, Sullivan, MO 63080-2359 | 2006-04-17 |
| 1063415073 | King's Medical Imaging Creve Coeur, LLC | Physiological Laboratory | 11756 Olive Street Rd, Creve Coeur, MO 63141 | 2005-05-23 |
| 1215397153 | Missouri Diagnostic Services, LLC | Physiological Laboratory | 1517 Copper Rd, Holts Summit, MO 65043-2033 | 2016-03-04 |
| 1417325143 | Biomedical Imaging LLC | Physiological Laboratory | 3450 Bridgeland Dr, Suite F, Bridgeton, MO 63044-2605 | 2015-09-11 |
| 1902239338 | Biomedical Imaging LLC | Physiological Laboratory | 3450 Bridgeland Dr, Suite F, Bridgeton, MO 63044-2605 | 2013-08-21 |
| 1821301342 | Respiratory Diagnostics, LLC | Physiological Laboratory | 11004 E 40 Hwy, Suite 124, Independence, MO 64055-6023 | 2010-07-26 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
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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.