PRIME HEALTHCARE SERVICES BLUE SPRINGS, LLC


Address: 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513
Phone: 8162285900

PRIME HEALTHCARE SERVICES BLUE SPRINGS, LLC (NPI# 1962809947) 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) 1962809947
Entity Type Organization
Organization Name PRIME HEALTHCARE SERVICES BLUE SPRINGS, LLC
Other Organization Name ST. MARY'S HOSPITAL
Practice Address 201 Nw R D Mize Rd
Blue Springs
MO 64014-2513
Practice Telephone 8162285900
Mailing Telephone 8162285900
Enumeration Date 2014-11-19
Last Update Date 2014-11-19
Authorized Official Name PREM REDDY (CHAIRMAN/PRESIDENT)
Authorized Official Telephone 9092354400
Authorized Official Credential M.D.
Is Organization Subpart Y
Parent Organization Name PRIME HEALTHCARE SERVICES BLUE SPRINGS, LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 273Y00000X Rehabilitation Unit 403-20 MO Hospital Units

Other Provider Identifier

State Issuer Identifier Type Code
MO 11444403 05
TRICARE 431284526 01

Other Provider/Organization Names

Other Name Type Code
St. Mary's Hospital Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1912303579 Prime Healthcare Services Blue Springs, LLC General Acute Care Hospital 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 2014-11-10

Office Location

Street Address 201 NW R D MIZE RD
City BLUE SPRINGS
State MO
Zip Code 64014-2513

Providers in the same location

NPI Name Taxonomy Address Enumeration
1831197680 Olga Alex Chernyak Nurse Anesthetist, Certified Registered 201 Nw R D Mize Rd, St. Mary's Medical Center/anesthesia Services of Blue S, Blue Springs, MO 64014-2513 2005-07-13
1053933150 Corey Pagnotta Surgery 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 2020-05-12
1104446376 Benjamin Joel Koerner Student in an Organized Health Care Education/Training Program 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 2020-04-17
1336789973 Elizabeth Jonelle Martin Physical Therapist 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 2020-01-12
1780157172 Spine Pain and Rehab Associates LLC Physical Medicine & Rehabilitation 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 2019-01-08
1306315692 Jackson Emergency Physicians LLC Emergency Medicine 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 2018-11-16
1952896748 Sally Emma Smith Surgery 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 2018-06-25
1851812945 Luke Clippard Surgery 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 2017-06-29
1982125076 Troy Tyler Surgery 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 2017-06-29
1255860029 Michael Andrew Roth Anesthesiologist Assistant 201 Nw R D Mize Rd, Blue Springs, MO 64014-2513 2017-06-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437756319 Ltaj Properties LLC Physical Therapist 514 Nw State 7 Hwy, Suite A, Blue Springs, MO 64014 2020-10-05
1790397198 Miranda Bramble Pharmacist 1701 Nw Highway 7, Blue Springs, MO 64014 2020-08-18
1659915098 Cheif Smiles LLC Dentist 620 E. Us Highway 40, Blue Springs, MO 64014 2019-10-29
1629637764 Beau Devereux Butzirus Dentist 1125 South Mo-7, Blue Springs, MO 64014 2019-06-12
1245725605 Brian Geraghty Orthopaedic Surgery 201 Nw R D Mize Road, Blue Springs, MO 64014 2018-06-28
1588101224 Andy Anderson Prevention Professional 2705 Nw 3rd Ter, Blue Springs, MO 64014 2017-01-19
1801250469 Louis Spear Dentist 1215 A Nw 7 Highway, Blue Springs, MO 64014 2016-04-11
1083027411 Alex Sharifian Dds Blue Springs Dentistry PC Dentist 1205 Ne Coronado Drive, Blue Springs, MO 64014 2014-06-03
1730512336 Valerie Fombon Pharmacist 625 W 40 Hwy, Blue Springs, MO 64014 2013-08-19
1356692750 Central Jackson County Fire Protection District Ambulance 805 Ne Jefferson St, Blue Springs, MO 64014 2012-09-25
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Taxonomy Information

Taxonomy Code 273Y00000X
Grouping Hospital Units
Classification Rehabilitation Unit

Taxonomy Definition

In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services.
Notes: Source: Code of Federal Regulations #42, Section 412.29.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1457864944 Mcclay Health and Rehab LLC Rehabilitation Unit 3801 Mcclay Rd, Saint Peters, MO 63376-7327 2017-11-07
1841385093 Heartland Regional Medical Center Rehabilitation Unit 5325 Faraon, Saint Joseph, MO 64506-3398 2006-10-04
1790239895 Karin Derigne Rehabilitation Unit 1101 Highway K, O Fallon, MO 63366-8431 2016-08-08
1801275466 Harley Grant Beck Rehabilitation Unit 3950 Newman Rd, Joplin, MO 64801-1512 2015-05-28
1134506611 Department of Veterans Affairs Rehabilitation Unit 915 N Grand Blvd, Saint Louis, MO 63106-1621 2015-05-04
1033596234 Hannibal Regional Healthcare System Inc Rehabilitation Unit 6000 Hospital Dr, Hannibal, MO 63401-6887 2015-04-27
1558767624 Prime Healthcare Services Kansas City, LLC Rehabilitation Unit 1000 Carondelet Dr, Kansas City, MO 64114-4673 2014-11-17
1063700862 Springfield Neurological and Spine Institute Rehabilitation Unit 3535 S National Ave, Springfield, MO 65807-7310 2011-07-13
1508192543 Mercy Hospital Joplin Rehabilitation Unit 2817 Saint Johns Blvd, Joplin, MO 64804-1563 2009-10-27
1659522829 Supplemental Rehabilitation Unit 20 Ne Saint Lukes Blvd, Suite 100, Lees Summit, MO 64086-6001 2008-10-07
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Competitor

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City BLUE SPRINGS
Zip Code 64014

Improve Information

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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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