MERCY HOSPITAL LEBANON (NPI# 1043562358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043562358 |
Entity Type | Organization |
Organization Name | MERCY HOSPITAL LEBANON |
Other Organization Name | MERCY SURGERY CENTER-LEBANON AT ROLLA |
Practice Address |
1605 Martin Springs Dr Rolla MO 65401-2931 |
Practice Telephone | 4178202818 |
Mailing Telephone | 4178202818 |
Enumeration Date | 2012-10-10 |
Last Update Date | 2013-05-10 |
Authorized Official Name | MR. SCOTT REYNOLDS (VP-FINANCE) |
Authorized Official Telephone | 4178202818 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Mercy Surgery Center-Lebanon at Rolla | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578901773 | Mercy Hospital Lebanon | Clinic/Center | 120 Hospital Dr, Suite 225, Lebanon, MO 65536-9238 | 2013-06-10 |
1912345257 | Mercy Hospital Lebanon | Clinic/Center | 608 Old Route 66, Saint Robert, MO 65584-3730 | 2013-06-10 |
1558709071 | Mercy Hospital Lebanon | Clinic/Center | 331 Hospital Dr, Suite C, Lebanon, MO 65536-9217 | 2013-06-06 |
1366880874 | Mercy Hospital Lebanon | Clinic/Center | 120 Hospital Dr, Suite 100, Lebanon, MO 65536-9238 | 2013-06-06 |
1437596160 | Mercy Hospital Lebanon | Clinic/Center | 904 S Pine St, Richland, MO 65556-7393 | 2013-06-04 |
1235576943 | Mercy Hospital Lebanon | Clinic/Center | 118 W Dallas St, Buffalo, MO 65622-8669 | 2013-06-04 |
1457798167 | Mercy Hospital Lebanon | Clinic/Center | 120 Hospital Dr, Suite 300/350, Lebanon, MO 65536-9238 | 2013-06-04 |
1801148499 | Mercy Hospital Lebanon | Radiology | 1605 Martin Springs Dr, Rolla, MO 65401-2982 | 2012-10-08 |
1740413988 | Mercy Hospital Lebanon | General Acute Care Hospital | 1605 Martin Springs Dr, Rolla, MO 65401-2931 | 2009-09-03 |
1053346320 | Mercy Hospital Lebanon | Medicare Defined Swing Bed Unit | 100 Hospital Dr, Lebanon, MO 65536 | 2006-07-12 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | MERCY HOSPITAL LEBANON | 100 Hospital Dr, Lebanon, MO 65536-9210 |
Street Address |
1605 MARTIN SPRINGS DR |
City | ROLLA |
State | MO |
Zip Code | 65401-2931 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124024468 | William S Anast | Anesthesiology | 1605 Martin Springs Dr, Rolla, MO 65401-2982 | 2005-06-22 |
1477092906 | Amanda Creamer | Nurse Practitioner | 1605 Martin Springs Dr, Ste 210, Rolla, MO 65401-2982 | 2017-02-16 |
1851839716 | Richard Siska Sr. | Radiologic Technologist | 1605 Martin Springs Dr, Ste 110, Rolla, MO 65401-2982 | 2017-02-10 |
1922457712 | Madhura G Joag | Internal Medicine | 1605 Martin Springs Dr, Rolla, MO 65401-2982 | 2016-06-13 |
1497115497 | Di'ara Woods | Physician Assistant | 1605 Martin Springs Dr, Ste 230, Rolla, MO 65401-2982 | 2016-03-03 |
1104260090 | Omofolarin Babatunji Fasuyi | Family Medicine | 1605 Martin Springs Dr, Suite 210, Rolla, MO 65401-2982 | 2013-04-22 |
1790037950 | Lisa A Cunningham | Nurse Practitioner | 1605 Martin Springs Dr, Ste 250, Rolla, MO 65401-2931 | 2012-10-11 |
1801148499 | Mercy Hospital Lebanon | Radiology | 1605 Martin Springs Dr, Rolla, MO 65401-2982 | 2012-10-08 |
1265787741 | Cheri Berti | Pharmacist | 1605 Martin Springs Dr, Suite 220, Rolla, MO 65401-2931 | 2012-07-19 |
1720347867 | Abigail Crisostomo | Family Medicine | 1605 Martin Springs Dr, Ste 210, Rolla, MO 65401-2931 | 2012-05-10 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639645591 | Samantha Jo Mitchell | Pharmacist | 1375 E 10th St Suite B, Rolla, MO 65401 | 2018-10-18 |
1427567726 | Gerry Wade Funkhouser Jr. | Counselor | 103 W 10th St, Rolla, MO 65401 | 2017-09-29 |
1366967960 | Shana Hintz Wisniewski | Social Worker | 1000 W. 10th St., Rolla, MO 65401 | 2017-08-04 |
1174066559 | Tabitha Hundt | Counselor | 1011 Cypress Dr, Rolla, MO 65401 | 2016-12-02 |
1841742855 | Alpha Assisted Living LLC | Assisted Living Facility | 13450 Cr 7040, 803 E 12th St, Rolla, MO 65401 | 2016-10-26 |
1275916884 | Elizabeth Zersen | Occupational Therapist | 2053 Vienna Rd, Rolla, MO 65401 | 2015-06-30 |
1386047025 | Becky L Witham | Nurse Practitioner | 1060 W 10th Street, Rolla, MO 65401 | 2014-10-08 |
1114326121 | Summer Adey | Licensed Practical Nurse | 13750 State Route F, Rolla, MO 65401 | 2014-08-14 |
1518303296 | Leaetta Mildred Gardner | Nursing Facility/Intermediate Care Facility | 13450 County Road 7040, Rolla, MO 65401 | 2013-05-21 |
1316282064 | Susan Peitz Gruener | Occupational Therapy Assistant | 1800 White Column Road, Rolla, MO 65401 | 2012-12-06 |
Find all providers in zip 65401 |
Taxonomy Code | 261QA1903X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Ambulatory Surgical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710926589 | Physician Surgery Center LLC | Clinic/Center | 1500 Highway 72 East, Rolla, MO 65401 | 2006-06-06 |
1619266426 | Rolla Surgical Clinic, LLC | Clinic/Center | 1210 Homelife Plz, Rolla, MO 65401-2512 | 2011-04-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790393130 | United Surgical Center, LLC | Clinic/Center | 638 Chamblee Ln, Creve Coeur, MO 63141-7323 | 2020-07-22 |
1801443320 | St. Luke's Surgery Center of Chesterfield, LLC | Clinic/Center | 111 St. Luke's Center Drive, Bldg B, Suite 500, Chesterfield, MO 63017-3509 | 2019-08-20 |
1255991238 | Lee Summit Asc Kc LLC | Clinic/Center | 2861 Ne Independence Avenue, Suite 101, Lee's Summitt, MO 64064 | 2019-06-20 |
1467925180 | Metro St Louis Surgery Center LLC | Clinic/Center | 1035 Bellevue Ave Ste 117, Saint Louis, MO 63117-1854 | 2019-01-04 |
1295207587 | Commons South Surgery Center, LLC | Clinic/Center | 12345 W Bend Dr Ste 201, Saint Louis, MO 63128-2254 | 2018-12-26 |
1922574391 | The Phoenix Oversight and Consulting, LLC. | Clinic/Center | 7746 Rannells Ave, Saint Louis, MO 63143-1823 | 2018-10-23 |
1700363611 | Apollo Ambulatory Surgery Center, LLC | Clinic/Center | 10012 Manchester Rd, Saint Louis, MO 63122-1826 | 2018-07-24 |
1336649565 | Advanced Surgical Care of St. Louis, LLC | Clinic/Center | 232 Mayfair Plaza Shopping Ctr, Florissant, MO 63033-8009 | 2018-02-14 |
1730698374 | Advanced Surgical Center of Sunset Hills LLC | Clinic/Center | 4594 S Lindbergh Blvd, Saint Louis, MO 63127 | 2017-09-27 |
1093224297 | United Physicians Group, LLC | Clinic/Center | 1100 Town and Country Commons Dr # 7805, Town and Country, MO 63017-8285 | 2017-09-20 |
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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.