Magnolia Hospitality Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MAGNOLIA HOSPITALITY INC.

Practice address

2475 Broadway Bluffs Drive
Ste. 301
Columbia, MO 65201-8128

Phone

(573) 874-3235

Fax

(573) 817-5917

NPI assigned

Sep 27, 2006

Organization subpart

No

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

Authorized official

Name

Rachna Puri

Title

Office Manager

Phone

(573) 874-3235

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Magnolia Critical Care and Internal Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cathy A. Hartle, FNP

  • Family Nurse Practitioner
  • Wellsville, MO
  • NPI 1669598710
  Medicare reassignment NPD
• Raman Puri, M.D.

  • Internal Medicine Physician
  • Columbia, MO
  • NPI 1295756906
  Medicare reassignment NPD

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1306937974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 BROADWAY BLUFFS DRIVE",
            "address_2": "STE. 301",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018128",
            "telephone_number": "573-874-3235",
            "fax_number": "573-817-5917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 BROADWAY BLUFFS DRIVE",
            "address_2": "STE. 301",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018128",
            "telephone_number": "573-874-3235",
            "fax_number": "573-817-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA HOSPITALITY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "PURI",
        "authorized_official_first_name": "RACHNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "573-874-3235"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509179305",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Critical Care and Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andres Madrid, MD
• Tinashe Maduke, MD, MPH
• Paula Magalhaes-Barton
• Joseph David Magee III, M.D.
• Reggie Eugene Maggard, CRNA
• Kaitlin Maguire, CRNA
• Reiana Jo Mahan, MD
• Muddassar Mahboob, MD
• Amin Mahdi, M.D.
• Eman S Mahdi, MD

• Internal Medicine Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.