MERCY HOSPITAL LEBANON (NPI# 1740413988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740413988 |
| Entity Type | Organization |
| Organization Name | MERCY HOSPITAL LEBANON |
| Other Organization Name | MERCY HOSPITAL LEBANON |
| Practice Address |
1605 Martin Springs Dr Rolla MO 65401-2931 |
| Mailing Address |
100 Hospital Dr Lebanon MO 65536-9210 |
| Practice Telephone | 4175336100 |
| Practice Fax Number | 4175336173 |
| Mailing Telephone | 4175336100 |
| Mailing Fax Number | 4175336173 |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2012-02-01 |
| Authorized Official Name | MR. MICHAEL J GILLEN (PRESIDENT) |
| Authorized Official Telephone | 4175336012 |
| Is Organization Subpart | Y |
| Parent Organization Name | BREECH REGIONAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 456-10 | MO | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | HEALTHLINK COMMERCIAL | 114678 | 01 |
| MO | 010492007 | 05 | |
| MO | 540492006 | 05 |
| Other Name | Type Code |
|---|---|
| Mercy Hospital Lebanon | 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 |
| 1043562358 | Mercy Hospital Lebanon | Clinic/Center | 1605 Martin Springs Dr, Rolla, MO 65401-2931 | 2012-10-10 |
| 1801148499 | Mercy Hospital Lebanon | Radiology | 1605 Martin Springs Dr, Rolla, MO 65401-2982 | 2012-10-08 |
| 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 |
| 1043562358 | Mercy Hospital Lebanon | Clinic/Center | 1605 Martin Springs Dr, Rolla, MO 65401-2931 | 2012-10-10 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891766051 | Phelps County Regional Medical Center | General Acute Care Hospital | 1000 W 10th St, Rolla, MO 65401-2905 | 2006-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295274256 | St. Lukes Health System | General Acute Care Hospital | 8101 N Lawndale Ave, Unit 2a, Kansas City, MO 64119-7808 | 2017-02-22 |
| 1093265159 | Missouri Delta Medical Center | General Acute Care Hospital | 2856 Vista Ridge Pl, Jackson, MO 63755-8105 | 2016-10-12 |
| 1285082040 | Jessica Teschner | General Acute Care Hospital | 3201 Ballard Mill Dr, Columbia, MO 65203-1875 | 2016-06-01 |
| 1912368002 | Emily Daniels | General Acute Care Hospital | 1737 Redbird Cv, Saint Louis, MO 63144-1610 | 2016-03-16 |
| 1225415417 | Parkland Veterinary Services, Inc. | General Acute Care Hospital | 615 E Karsch Blvd, Farmington, MO 63640-1225 | 2015-04-27 |
| 1841698164 | Mercy Clinic East Community | General Acute Care Hospital | 1021 Darwick Ct, Saint Louis, MO 63132-2909 | 2014-12-18 |
| 1831523695 | Saint Francis Medical Center | General Acute Care Hospital | 150 South Mount Auburn Road, Suite 342, Cape Girardeau, MO 63703 | 2013-08-29 |
| 1730528662 | Barnes Jewish Hospital | General Acute Care Hospital | 4512 Cleveland Ave, Apt 12, Saint Louis, MO 63110-3318 | 2013-06-25 |
| 1366796757 | Barnes Jewish Hospital | General Acute Care Hospital | 2180 Splendor Dr, Florissant, MO 63031-2640 | 2012-11-06 |
| 1952651341 | Faisal Alasmari | General Acute Care Hospital | 13928 Reflection Drive, Reflection Cove Apartments, Apt#235, Ballwin, MO 63021 | 2012-09-13 |
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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.