CROSS TRAILS MEDICAL CENTER (NPI# 1841508264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1841508264 |
Entity Type | Organization |
Organization Name | CROSS TRAILS MEDICAL CENTER |
Practice Address |
307 Gabriel St Advance MO 63730 |
Practice Telephone | 5737223034 |
Practice Fax Number | 5737223244 |
Mailing Telephone | 5733320808 |
Mailing Fax Number | 5733395803 |
Enumeration Date | 2010-09-20 |
Last Update Date | 2010-09-20 |
Authorized Official Name | MONA WELLS (CFO) |
Authorized Official Telephone | 5733391196 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
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 |
1811051642 | Cross Trails Medical Center | Clinic/Center | 408 S Broadview St, Cape Girardeau, MO 63703-5725 | 2006-12-19 |
1821151622 | Cross Trails Medical Center | Clinic/Center | 109 Hwy 51 North, Marble Hill, MO 63764 | 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 |
307 GABRIEL ST |
City | ADVANCE |
State | MO |
Zip Code | 63730 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154583987 | John Carl Graf IIi | Dentist | 307 Gabriel St, Advance, MO 63730-0039 | 2008-07-02 |
1265734941 | Beverly Jaye Dillow | Dental Hygienist | 307 Gabriel St, Advance, MO 63730-0039 | 2010-12-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689292302 | Kimberly Backfisch | Counselor | 105b N Oak St, Advance, MO 63730 | 2020-07-09 |
1306272653 | Phelps In-home Care, LLC | In Home Supportive Care | 201 W. Sturdivant St., Advance, MO 63730 | 2013-09-18 |
1265691869 | Advance Medical Clinic | Clinic/Center | 103 South Oak Street, Advance, MO 63730 | 2008-06-09 |
1063620565 | Jerrilyn D Adkisson | Point of Service | 24777 State Hwy 25, Advance, MO 63730 | 2007-05-18 |
1063553402 | Advance R-iv Public Schools | Local Education Agency (LEA) | 19805 State Hwy C, Advance, MO 63730 | 2007-02-09 |
1154476919 | Cindy Beussink | Speech-Language Pathologist | 19134 County Rd 208, Advance, MO 63730 | 2007-01-24 |
1225191752 | Cross Trails Medical Center | Clinic/Center | 307 Gabriel St., Advance, MO 63730 | 2006-12-18 |
1346356177 | Haven Health Cares | Clinic/Center | 502 West Sturdivant Street, Advance, MO 63730 | 2006-08-22 |
1326242645 | Mary Diane Reeves | Speech-Language Pathologist | 19805 State Hwy C, Box 370, Advance, MO 63730 | 2007-06-12 |
1952582223 | Miranda D Sauceda | Clinic/Center | 502 West Sturdivant, Advance, MO 63730-0137 | 2007-11-15 |
Find all providers in zip 63730 |
Taxonomy Code | 1223G0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | General Practice |
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
Notes: Source: Academy of General Dentistry |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154583987 | John Carl Graf IIi | Dentist | 307 Gabriel St, Advance, MO 63730-0039 | 2008-07-02 |
1437373883 | Adam T. Dorsett | Dentist | 127 Royal Troon Ln, Advance, NC 27006 | 2007-04-13 |
1912121393 | Adam T. Dorsett, Dds, and Jason T. Moore, Dds, Pa | Dentist | 127 Royal Troon Lane, Advance, NC 27006-6651 | 2007-04-13 |
1861583882 | Todd H Carter | Dentist | 123 Nc Hwy 801 South, C-100, Advance, NC 27006 | 2006-09-27 |
1881218006 | Cody Matthew Sabol | Dentist | 127 Royal Troon Ln, Advance, NC 27006-6970 | 2020-06-03 |
1083238315 | Courtney Rose | Dentist | 127 Royal Troon Ln, Advance, NC 27006-6970 | 2020-06-02 |
1497162895 | Liner, Ward & Shobe Dds, Pa | Dentist | 135 Medical Dr, Advance, NC 27006-6684 | 2014-07-17 |
1881006021 | Jeffrey William Duffy | Dentist | 127 Royal Troon Ln, Advance, NC 27006-6970 | 2014-05-22 |
1457645046 | Daniel Gregg Moore | Dentist | 127 Royal Troon Lane, Advance, NC 27006-6651 | 2011-06-01 |
1013058700 | Thomas S. Browder | Dentist | 5380 Us Highway 158, Suite 200, Advance, NC 27006-6907 | 2007-02-08 |
Find all providers in ADVANCE |
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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.