CROSS TRAILS MEDICAL CENTER (NPI# 1821151622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821151622 |
| Entity Type | Organization |
| Organization Name | CROSS TRAILS MEDICAL CENTER |
| Practice Address |
109 Hwy 51 North Marble Hill MO 63764 |
| Mailing Address |
Po Box 349 Marble Hill MO 63764-0349 |
| Practice Telephone | 5732382725 |
| Practice Fax Number | 5732383795 |
| Mailing Telephone | 5732382725 |
| Mailing Fax Number | 5732389795 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | VICKI A SMITH (CEO) |
| Authorized Official Telephone | 5733320808 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225191752 | Cross Trails Medical Center | Clinic/Center | 307 Gabriel St., Advance, MO 63730 | 2006-12-18 |
| 1962565499 | Cross Trails Medical Center | Clinic/Center | 109 Hwy 51 North, Marble Hill, MO 63764 | 2006-12-18 |
| 1972925444 | Cross Trails Medical Center | Dentist | 1314 Brenda Ave, Perryville, MO 63775-2624 | 2014-01-17 |
| 1215368402 | Cross Trails Medical Center | Clinic/Center | 1314 Brenda Ave, Perryville, MO 63775-2624 | 2013-12-12 |
| 1841508264 | Cross Trails Medical Center | Dentist | 307 Gabriel St, Advance, MO 63730 | 2010-09-20 |
| 1811051642 | Cross Trails Medical Center | Clinic/Center | 408 S Broadview St, Cape Girardeau, MO 63703-5725 | 2006-12-19 |
| 1356393268 | Cross Trails Medical Center | Clinic/Center | 408 S Broadview St, Cape Girardeau, MO 63703-5725 | 2006-05-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CROSS TRAILS MEDICAL CENTER | 408 S Broadview St, Cape Girardeau, MO 63703-5725 |
| Street Address |
109 HWY 51 NORTH |
| City | MARBLE HILL |
| State | MO |
| Zip Code | 63764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962565499 | Cross Trails Medical Center | Clinic/Center | 109 Hwy 51 North, Marble Hill, MO 63764 | 2006-12-18 |
| 1730218827 | Joesph D Cravens | Dental Hygienist | 109 Hwy 51 North, Marble Hill, MO 63764 | 2007-03-05 |
| 1952464372 | Patricia Merkley | Dentist | 109 Hwy 51 North, Marble Hill, MO 63764 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982201935 | J & J Assisted Living LLC | Assisted Living Facility | 104 Wesbecher Ln, Marble Hill, MO 63764 | 2020-10-02 |
| 1497310932 | Select Physical Therapy Holdings, Inc. | Clinic/Center | 201 Highway 34 West, Marble Hill, MO 63764 | 2019-05-09 |
| 1467950196 | Ronald Brand | Counselor | 103 El Nathan Drive, Marble Hill, MO 63764 | 2018-01-29 |
| 1053827964 | Dianas Boarding Home Inc | Community Based Residential Treatment Facility, Mental Illness | Hc 64, Box 4683, Marble Hill, MO 63764 | 2017-12-15 |
| 1699293274 | Alyssa Naschell Grado | Physical Therapist | 702-mo 34, Marble Hill, MO 63764 | 2017-09-05 |
| 1063969699 | Julie Elfrink | Registered Nurse | 107 N. Hwy 51, Marble Hill, MO 63764 | 2016-09-01 |
| 1194022921 | Suzanne Raye Matthews | Nurse Practitioner | 307 Broadway, Marble Hill, MO 63764 | 2011-02-14 |
| 1619281789 | Ryan Michael Sutterer | Optometrist | 503 W. Main Street, Marble Hill, MO 63764 | 2010-08-01 |
| 1215267976 | L. Mark Milde | Dentist | 101 First St., Marble Hill, MO 63764 | 2009-12-31 |
| 1194985739 | J & J Assistive Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 104 Wesbecher, Marble, MO 63764 | 2008-06-16 |
| Find all providers in zip 63764 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306444740 | Ressel Family Dentistry LLC | Clinic/Center | 1 E Broadway Ste A, Columbia, MO 65203-4205 | 2020-10-16 |
| 1467059980 | Valudental Independence LLC | Clinic/Center | 600 E Us Highway 24, Independence, MO 64050-2910 | 2020-10-07 |
| 1144835828 | Rem Dds, LLC | Clinic/Center | 10000 Watson Rd Ste 2mm, Saint Louis, MO 63126-1848 | 2020-09-10 |
| 1043824832 | Pleasant Dental Care Kc | Clinic/Center | 912 E 63rd St Ste 100, Kansas City, MO 64110-3439 | 2020-08-31 |
| 1164033122 | Dental Depot of Blue Springs Pllc | Clinic/Center | 1500 S 7 Hwy, Blue Springs, MO 64014-3943 | 2020-08-13 |
| 1184235517 | Twin Creeks Family Dentistry LLC | Clinic/Center | 10560 N Ambassador Dr Ste 200, Kansas City, MO 64153-1591 | 2020-08-10 |
| 1003434234 | Jason L Allen Dmd LLC | Clinic/Center | 5147 Daggett Ave, Saint Louis, MO 63110-3009 | 2020-07-14 |
| 1538622071 | Smile Safari of Missouri | Clinic/Center | 10016 E 63rd St, Raytown, MO 64133-5102 | 2019-04-11 |
| 1275094864 | Itooth Family Dentistry, LLC | Clinic/Center | 3211 E Battlefield St Ste 100, Springfield, MO 65804-4071 | 2019-03-27 |
| 1033677901 | C. Hastings, Dds, LLC | Clinic/Center | 1709 Heritage Hills Dr, Washington, MO 63090-4621 | 2019-03-08 |
| Find all providers with the same taxonomy | ||||
| City | MARBLE HILL |
| Zip Code | 63764 |
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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.