MIDWEST MOBILE IMAGING


Address: 408 Washington Ave Ste 130, West Plains, MO 65775-3404
Phone: 8884269210

MIDWEST MOBILE IMAGING (NPI# 1760855043) 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) 1760855043
Entity Type Organization
Organization Name MIDWEST MOBILE IMAGING
Practice Address 408 Washington Ave Ste 130
West Plains
MO 65775-3404
Mailing Address Po Box 4241
Springfield
MO 65808-4241
Practice Telephone 8884269210
Practice Fax Number 8884269214
Mailing Telephone 8884269210
Mailing Fax Number 8884269214
Enumeration Date 2015-11-09
Last Update Date 2019-08-30
Authorized Official Name DANIEL TAYLOR (OWNER)
Authorized Official Telephone 8884269210
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 293D00000X Physiological Laboratory Laboratories

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
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

Office Location

Street Address 408 WASHINGTON AVE STE 130
City WEST PLAINS
State MO
Zip Code 65775-3404

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1295184166 Shaunda Faye Wolfe Case Manager/Care Coordinator 2301 K Hwy Apt. 2, West Plains, MO 65775 2016-06-10
1740694009 Mary Loretta Rogganbuck Counselor 1211 Porter Wagoner #23, West Plains, MO 65775 2014-06-16
1548673858 John Tollenaar Physical Therapist 1480 8th Streeet, West Plains, MO 65775 2014-06-04
1861818080 Raymond Eugene Richardson Case Manager/Care Coordinator 1015 Lanton Road, West Plains, MO 65775 2014-03-12
1710309083 Jared M Sadowitz Physical Therapist 1100 Kentucly Ave, West Plains, MO 65775 2014-01-06
1346682184 Mark L. Dake Dds, Msd and David Sander Dmd, Mds Dentist 181 N. Kentucky, Suite 300, West Plains, MO 65775 2013-07-22
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Taxonomy Information

Taxonomy Code 293D00000X
Grouping Laboratories
Classification Physiological Laboratory

Taxonomy Definition

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.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1750757415 Mobilis Health, LLC Physiological Laboratory 4240 Duncan Ave, Second Floor, Saint Louis, MO 63110-1123 2015-08-18
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
1437108842 Biotech X-ray Inc Physiological Laboratory 1065 Executive Parkway Dr Ste 220, Saint Louis, MO 63141-6367 2006-05-10
1235194002 Sleep Kwest, LLC Physiological Laboratory 101b Progress Pkwy, Sullivan, MO 63080-2359 2006-04-17
1710971080 Specialized Imaging Services, Inc. Physiological Laboratory 9785 Mackenzie Rd, Suite 101, Saint Louis, MO 63123-5438 2005-09-01
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
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Competitor

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City WEST PLAINS
Zip Code 65775

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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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