NPIMap

Organization Active NPI

Northwest Medical Center Association Inc

Doing business as Mosaic Medical Center Albany

  • Medicare Defined Swing Bed Hospital Unit
  • Albany, MO
National Provider Identifier
1124164322
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
98-48 Issued in MO
Legal business name
NORTHWEST MEDICAL CENTER ASSOCIATION INC
Doing business as
Mosaic Medical Center Albany
Northwest Medical Center
Practice address
705 N College St
Albany, MO 64402-1433
Phone
(660) 726-3941
Fax
(660) 726-3647
NPI assigned
Jan 29, 2007
Last updated
Sep 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHWEST MEDICAL CENTER ASSOCIATION, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dwight Carvell
Title
Director of Reimbursement
Phone
(816) 271-0437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 98-48 MO Primary

Addresses

Primary practice location

705 N College St
Albany, MO 64402-1433

Mailing address

705 N College St
Albany, MO 64402-1433
Phone (660) 726-3941

Other identifiers 1

IdentifierTypeStateIssuer
010158301MedicaidMO

Other names 2

  • Mosaic Medical Center Albany Doing business as
  • Northwest Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040224000204 MO Part B Supplier - Clinic/Group Practice 5496641896 Receives reassigned benefits from 205 practitioners
8 other NPIs on this enrollment
Practice locations: Albany, MO; Grant City, MO; New Hampton, MO; Stanberry, MO
O20111208000726 MO Part A Provider - Critical Access Hospital 5496641896 Practice locations: Albany, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124164322. Details of each certification follow.

Hospital certification: CCN 26Z328

Legal name
NORTHWEST MEDICAL CENTER ASSOCIATION INC
Doing business as
MOSAIC MEDICAL CENTER ALBANY
Organization structure
OtherNon-profit
Incorporated
Jun 24, 1954 in MO
Enrollment address
705 N College St
Albany, MO 64402-1433
Hospital Swing-Bed Unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Albany Physician Clinic

Locations

16 W 4th St
#187
Grant City, MO 64456
Phone (660) 564-3322

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Renee Hayes Individual W-2 Managing Employee Sep 24, 2020
Dwight Carvell Individual Corporate DirectorDirector of Reimbursement Dec 2, 2021
Northwest Medical Center Association Inc Organization, Albany, MO Created for acquisition 5% Or Greater Direct Ownership Interest Oct 1, 1967 100%
Rachael Praiswater Individual W-2 Managing EmployeeProvider Enrollment Specialist Sep 28, 2020
Mosaic Health System Organization, Saint Joseph, MO 5% Or Greater Direct Ownership Interest Jan 1, 2015 100%
Cynthia G Patterson Individual W-2 Managing Employee Nov 1, 2017

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mosaic Medical Center AlbanyAlbany, MO, CCN 261328 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 1967
Mosaic Family Care New HamptonNew Hampton, MO, CCN 268702 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 9, 2013
Mosaic Family Care Grant CityGrant City, MO, CCN 268730 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2015

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 15

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 15

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 209

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 209

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1124164322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 N COLLEGE ST",
            "city": "ALBANY",
            "state": "MO",
            "postal_code": "644021433",
            "telephone_number": "660-726-3941",
            "fax_number": "660-726-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 N COLLEGE ST",
            "city": "ALBANY",
            "state": "MO",
            "postal_code": "644021433",
            "telephone_number": "660-726-3941",
            "fax_number": "660-726-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MEDICAL CENTER ASSOCIATION INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST MEDICAL CENTER ASSOCIATION, INC",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "CARVELL",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "816-271-0437"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MO",
            "license": "98-48",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010158301",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mosaic Medical Center Albany",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northwest Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, MO

Sources for this page

Verify at the official NPI Registry.