DIAMOND MEDICAL CARE LLC (NPI# 1770978413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770978413 |
| Entity Type | Organization |
| Organization Name | DIAMOND MEDICAL CARE LLC |
| Practice Address |
1101 Nw Pamela Blvd Suite A Grain Valley MO 64029-7841 |
| Practice Telephone | 8162951606 |
| Mailing Telephone | 8162951606 |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |
| Authorized Official Name | DR. BRAD MOUSE (PHYSICIAN) |
| Authorized Official Telephone | 8162951606 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
R9G82 | MO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1588604979 | 05 |
| Street Address |
1101 NW PAMELA BLVD SUITE A |
| City | GRAIN VALLEY |
| State | MO |
| Zip Code | 64029-7841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588604979 | Brad A. Mouse | Family Medicine | 1101 Nw Pamela Blvd, Suite A, Grain Valley, MO 64029-7841 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003324542 | Quad/med, LLC | Clinic/Center | 2015 Ne Jefferson Street, Grain Valley, MO 64029 | 2018-01-18 |
| 1336655299 | Cosentino Enterprises Inc | Pharmacy | 1191 Ne Mcquerry Road, Grain Valley, MO 64029 | 2017-12-14 |
| 1427238922 | Tracy Dee Dryer | Pharmacist | 301 Sw Eagle's Parkway, Grain Valley, MO 64029 | 2007-11-13 |
| 1184822736 | Center for The Developmentally Disabled | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1800 Nw Duncan Rd, Grain Valley, MO 64029 | 2007-07-05 |
| 1740486711 | Re-new Life | Counselor | 33204 E. R.d. Mize Road, Grain Valley, MO 64029 | 2007-06-26 |
| 1891822524 | Julia Rachele Loecker | Dentist | 1424 Sw Eagles Parkway, Grain Valley, MO 64029 | 2007-02-28 |
| 1578667192 | Bds Pharmaceutical Inc | Pharmacy | 1400 Sw Eagles Parkway, Grain Valley, MO 64029 | 2006-09-12 |
| 1376575480 | Kurt Frederick Hanneman | Dentist | 655 R.d. Mize Road, Grain Valley, MO 64029 | 2006-07-07 |
| 1144832569 | Crosetti Health and Wellness | Pharmacy | 510 N Main St, Grain Valley, MO 64029 | 2020-08-18 |
| 1528273471 | Katrina Marie Tarpenning | Pharmacist | 1400 Sw Eagles Pkwy, Grain Valley, MO 64029 | 2007-05-14 |
| Find all providers in zip 64029 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003324542 | Quad/med, LLC | Clinic/Center | 2015 Ne Jefferson Street, Grain Valley, MO 64029 | 2018-01-18 |
| 1568651438 | Alan J. Scharrer Md Inc. | Clinic/Center | 1454 Sw Eagles Pkwy, Grain Valley, MO 64029-8508 | 2007-10-17 |
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|---|---|---|---|---|
| 1174145668 | Essential Benefit Offerings, LLC | Clinic/Center | 1417 N Mount Auburn Rd Ste A2, Cape Girardeau, MO 63701-2171 | 2020-05-07 |
| 1114483468 | Your Optimal Healthcare LLC | Clinic/Center | 300 W 4th St Ste H, Eureka, MO 63025-1839 | 2019-02-12 |
| 1306313051 | Country Care Family Clinic, LLC | Clinic/Center | 3 E Cleveland Ave, Ellsinore, MO 63937 | 2018-10-31 |
| 1285118950 | Vera Whole Health, Wa PC | Clinic/Center | 8350 N. Church Road, Kansas City, MO 64158 | 2018-09-19 |
| 1093267601 | Careatc-saint Peter | Clinic/Center | 4601 Executive Centre Pkwy, Saint Peters, MO 63376-1683 | 2016-10-30 |
| 1407303480 | Kerns Family Health Care LLC | Clinic/Center | 1335 Vilage Dr B, St. Joseph, MO 64506-2457 | 2016-09-07 |
| 1316491020 | Wecare Tlc - Wwt Mo Family Health Center | Clinic/Center | 58 Weldon Pkwy, Bldg 58, Maryland Heights, MO 63043-3237 | 2016-08-10 |
| 1255703500 | Community Hospital Association | Clinic/Center | 101 South Washington Street, Oregon, MO 64473 | 2015-10-27 |
| 1023485752 | Dennis E. Robinson D.o. | Clinic/Center | 487 Pomme De Terre Dr., Marshfield, MO 65706 | 2015-08-28 |
| 1598144982 | Odessa Eye Care LLC | Clinic/Center | 201 N 2nd St Ste C, Odessa, MO 64076-1393 | 2015-05-19 |
| Find all providers with the same taxonomy | ||||
| City | GRAIN VALLEY |
| Zip Code | 64029 |
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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.