Mobile X-Ray Services LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

MOBILE X-RAY SERVICES LLC

Doing business as

Kosma Mobile X-Ray Co

Practice address

3050 N 20TH St
Ozark, MO 65721-5925

Phone

(417) 863-9729

Fax

(417) 863-0720

NPI assigned

Jun 22, 2007

Organization subpart

No

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

Authorized official

Name

Earl B Maes, M.D.

Title

President

Phone

(417) 863-9729

Specialties & licenses 1

Addresses

Other names 1

• Kosma Mobile X-Ray Co Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Portable X-ray supplier certification: CCN 26X0009808

Legal name

KOSMA MOBILE XRAY, INC

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Sep 20, 1984

Last certification

Nov 4, 2015

Ownership / control type

Corporation

Most recent change of ownership

Sep 15, 2007

Facility address

3050 N 20TH Street
Ozark, MO 65721

Locations

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413763200000",
    "number": "1376749812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 N 20TH ST",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657215925",
            "telephone_number": "417-863-9729",
            "fax_number": "417-863-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 N 20TH ST",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657215925",
            "telephone_number": "417-863-9729",
            "fax_number": "417-863-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE X-RAY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2014-10-20",
        "status": "A",
        "authorized_official_last_name": "MAES",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-863-9729",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kosma Mobile X-Ray Co",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Ozark, MO
• Providers in Ozark, MO by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.