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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 273Y00000X | Rehabilitation Unit | 403-20 | MO | Hospital Units |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 11444403 | 05 | |
TRICARE | 431284526 | 01 |
Other Name | Type Code |
---|---|
St. Mary's Hospital | Doing Business As Name - Organization |
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 |
Street Address |
201 NW R D MIZE RD |
City | BLUE SPRINGS |
State | MO |
Zip Code | 64014-2513 |
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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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 |
Find all providers in zip 64014 |
Taxonomy Code | 273Y00000X |
Grouping | Hospital Units |
Classification | Rehabilitation Unit |
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. |
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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City | BLUE SPRINGS |
Zip Code | 64014 |
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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.