MOSAIC MEDICAL CENTER - MARYVILLE (NPI# 1093289431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093289431 |
| Entity Type | Organization |
| Organization Name | MOSAIC MEDICAL CENTER - MARYVILLE |
| Other Organization Name | MOSAIC FAMILY CARE - SAVANNAH |
| Practice Address |
301 E Price Ave Ste A Savannah MO 64485-2482 |
| Practice Telephone | 8164320006 |
| Practice Fax Number | 8164320008 |
| Mailing Telephone | 8164320006 |
| Mailing Fax Number | 8164320008 |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2019-06-10 |
| Authorized Official Name | DWIGHT R CARVELL (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 8162730473 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Mosaic Family Care - Savannah | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184189797 | Mosaic Medical Center - Maryville | Internal Medicine | 2016 S Main St, Maryville, MO 64468-2655 | 2019-02-07 |
| 1205300498 | Mosaic Medical Center - Maryville | Family Medicine | 408 Dodge St, Bedford, IA 50833-1413 | 2019-01-22 |
| 1598239790 | Mosaic Medical Center - Maryville | Family Medicine | 114 E South Hills Dr, Maryville, MO 64468-2659 | 2019-01-22 |
| 1568936995 | Mosaic Medical Center - Maryville | Medicare Defined Swing Bed Unit | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
| 1477027803 | Mosaic Medical Center - Maryville | Psychiatric Unit | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
| 1265906663 | Mosaic Medical Center - Maryville | General Acute Care Hospital | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
| 1821562265 | Mosaic Medical Center - Maryville | Clinic/Center | 2016 S Main St, Maryville, MO 64468-2655 | 2019-01-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MOSAIC MEDICAL CENTER - MARYVILLE | 2016 S Main St, Maryville, MO 64468-2655 |
| Iowa Business Entities | MOSAIC MEDICAL CENTER - MARYVILLE | 2016 South Main, Maryville, MO 64468 |
| Street Address |
301 E PRICE AVE STE A |
| City | SAVANNAH |
| State | MO |
| Zip Code | 64485-2482 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346722022 | Andrea Crangle | Occupational Therapist | 13277 State Hwy D, Savannah, MO 64485 | 2018-08-30 |
| 1104348523 | Helen Machelle Skinner | Nurse Practitioner | 803 Us Hwy 71, Savannah, MO 64485 | 2017-07-07 |
| 1104947126 | Northwest Health Services, Inc | Family Medicine | 803 Highway 71 West, Savannah, MO 64485 | 2007-04-03 |
| 1720073174 | Rms Associates Inc | Pharmacy | 205 S 71 Hwy, Savannah, MO 64485 | 2005-09-13 |
| 1336144310 | Thomas David Rucker | Dentist | 1107 S. Catalpa St., Savannah, MO 64485 | 2005-06-16 |
| 1316447550 | Tmh Associates LLC | Pharmacy | 205 S 71 Hwy, Savannah, MO 64485 | 2018-02-14 |
| 1609947043 | Rebecca J Rotterman | Pharmacist | 205 S 71 Hwy, Savannah, MO 64485 | 2006-11-09 |
| 1700923745 | Poirier Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 102 So 5th St, Savannah, MO 64485-0128 | 2007-01-31 |
| 1942362249 | Phlv, LLC | Skilled Nursing Facility | 904 Hall Ave, Savannah, MO 64485-0279 | 2006-12-14 |
| 1275626855 | Laverna Village Nursing Home Inc. | Skilled Nursing Facility | 904 Hall Avenue, Savannah, MO 64485-0279 | 2006-10-02 |
| Find all providers in zip 64485 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306280185 | Ssm Regional Health Services | Clinic/Center | 301 E Price Ave, Suite A, Savannah, MO 64485-2427 | 2013-04-23 |
| 1619412871 | Tennessee Family Clinic | Clinic/Center | 1565 Wayne Rd, Savannah, TN 38372 | 2016-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102137 | Washington County Memorial Hospital | Clinic/Center | 14206 Hwy C, Belgrade, MO 63622 | 2020-07-23 |
| 1891325072 | Scotland County Memorial Hospital | Clinic/Center | 55682 State Highway 6 Ste A, Edina, MO 63537-4268 | 2020-01-16 |
| 1639736457 | Southeast Health Center of Stoddard County LLC | Clinic/Center | 800 Us Highway 61, New Madrid, MO 63869-1106 | 2019-05-28 |
| 1134633456 | Pike County Memorial Hospital | Clinic/Center | 1420 S Business 61 Unit Fde, Bowling Green, MO 63334-5230 | 2017-11-22 |
| 1720505894 | Perry County Health System | Clinic/Center | 210 Hospital Ln Ste 202, Perryville, MO 63775-4200 | 2017-08-29 |
| 1427572007 | Missouri Delta Medical Center | Clinic/Center | 209 W Yoakum Ave, Chaffee, MO 63740-1138 | 2017-07-26 |
| 1790213676 | Jackson Primary Care LLC | Clinic/Center | 2685 E Main St Ste A, Jackson, MO 63755-2474 | 2017-05-23 |
| 1972050581 | Sgoh Acquisition, Inc. | Clinic/Center | 912b State Highway 59, Goodman, MO 64843-8252 | 2016-09-01 |
| 1144605312 | Nevada City Hospital | Clinic/Center | 627 S Ash St Ste B, Nevada, MO 64772 | 2015-07-29 |
| 1669856829 | Ssm Regional Health Services | Clinic/Center | 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 | 2015-07-16 |
| Find all providers with the same taxonomy | ||||
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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.