NPIMap

Organization Active NPI

Heartland Regional Medical Center

Doing business as Mosaic Life Care

  • General Practice Physician
  • Saint Joseph, MO
National Provider Identifier
1477575405
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
426-19 Issued in MO
Legal business name
HEARTLAND REGIONAL MEDICAL CENTER
Doing business as
Mosaic Life Care
Practice address
5325 Faraon St
Saint Joseph, MO 64506-3488
Phone
(816) 271-6000
Fax
(816) 271-7678
NPI assigned
Jul 25, 2006
Last updated
Jul 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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) 273-7835

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Anesthesiology) Physician 207LA0401X
Pain Medicine (Anesthesiology) Physician 207LP2900X 426-19 MO
Emergency Medicine Physician 207P00000X 426-19 MO
Family Medicine Physician 207Q00000X 426-19 MO
Internal Medicine Physician 207R00000X 426-19 MO
Cardiovascular Disease Physician 207RC0000X 426-19 MO
Neurological Surgery Physician 207T00000X 426-19 MO
Obstetrics & Gynecology Physician 207V00000X 426-19 MO
Otolaryngology Physician 207Y00000X 426-19 MO
Physical Medicine & Rehabilitation Physician 208100000X 426-19 MO
Plastic Surgery Physician 208200000X 426-19 MO
Neurology Physician 2084N0400X 426-19 MO
General Practice Physician 208D00000X 426-19 MO Primary
Hospitalist Physician 208M00000X 426-19 MO
Pain Medicine Physician 208VP0000X 426-19 MO

Addresses

Primary practice location

5325 Faraon St
Saint Joseph, MO 64506-3488

Mailing address

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-6000

Other identifiers 1

IdentifierTypeStateIssuer
540156809MedicaidMO

Other names 1

  • Mosaic Life Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS, IA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040225001201 MO Part B Supplier - Clinic/Group Practice 6709772767 Receives reassigned benefits from 471 practitioners
2 other NPIs on this enrollment
O20040518001007 KS Part B Supplier - Clinic/Group Practice 6709772767 Receives reassigned benefits from 21 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Atchison, KS; Atchisonc, KS; Hiawatha, KS; Hiwatha, KS; Seneca, KS; Troy, KS
O20120912000472 IA Part B Supplier - Clinic/Group Practice 6709772767 Receives reassigned benefits from 2 practitioners
Practice locations: Clarinda, IA

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

923 N Walnut St
Cameron, MO 64429
Phone (816) 632-1799

6420 N Prospect Ave
Gladstone, MO 64119
Phone (913) 945-9700

105 Far West Dr
Ste 100
Saint Joseph, MO 64506
Phone (816) 271-8110

1314 N 36th St
Saint Joseph, MO 64506
Phone (800) 952-8387

3715 Beck Rd
Ste F
Saint Joseph, MO 64506
Phone (816) 271-4935

5301 Faraon St
Ste 160
Saint Joseph, MO 64506
Phone (816) 364-3277

5301 Faraon St
Ste 210B
Saint Joseph, MO 64506
Phone (816) 271-1385

5514 Corporate Dr
Ste 120
Saint Joseph, MO 64507
Phone (816) 271-1350

711 N 36th St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-8120

901 Heartland Rd
#1905
Saint Joseph, MO 64506

1707 E 9th St
Trenton, MO 64683
Phone (660) 339-8500

Ownership & related parties

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 Life Care at St Joseph Medical CenterSaint Joseph, MO, CCN 260006 Hospital Operational/Managerial Control (100%) Nov 13, 2007
Mosaic Life Care Home HealthSaint Joseph, MO, CCN 267064 Home health agency Operational/Managerial Control Jul 1, 1987
Mosaic Life Care HospiceSaint Joseph, MO, CCN 261507 Hospice Operational/Managerial Control (100%) Jan 1, 1987

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 503

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 503

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1477575405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-6000",
            "fax_number": "816-271-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-6000",
            "fax_number": "816-271-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "CARVELL",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "816-273-7835"
    },
    "taxonomies": [
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": "426-19",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "426-19",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "426-19",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "426-19",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "426-19",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "426-19",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "426-19",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "426-19",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "426-19",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MO",
            "license": "426-19",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "426-19",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "426-19",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "426-19",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MO",
            "license": "426-19",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "540156809",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mosaic Life Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.