Northport Health Services of Missouri, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

NORTHPORT HEALTH SERVICES OF MISSOURI, LLC

Doing business as

Webb City Health & Rehabilitation Center

Practice address

2077 Stadium Dr
Webb City, MO 64870-9743

Phone

(417) 673-1933

NPI assigned

Jun 7, 2006

Last updated

Oct 9, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Phillip Cody Long

Title

Cfo

Phone

(205) 391-3600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Webb City Health & Rehabilitation Center Doing business as

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

CLIA laboratory certificates

Practitioners 3

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.

• Fernando Cavero, M.D.

  • Internal Medicine Physician
  • Sparta, MO
  • NPI 1669545711
  NPD (past)
• Edgar M. Conrad IV, D.O.

  • Internal Medicine Physician
  • Joplin, MO
  • NPI 1124055074
  NPD (past)
• Rajendrakumar I Patel, M.D.

  • Internal Medicine Physician
  • Webb City, MO
  • NPI 1578517421
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1487694618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2077 STADIUM DR",
            "city": "WEBB CITY",
            "state": "MO",
            "postal_code": "648709743",
            "telephone_number": "417-673-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2077 STADIUM DR",
            "city": "WEBB CITY",
            "state": "MO",
            "postal_code": "648709743",
            "telephone_number": "417-673-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHPORT HEALTH SERVICES OF MISSOURI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CODY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "205-391-3600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102259108",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Webb City Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Webb City Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Breck Alan Mitchell, PT, DPT
• Moc Webb City, P L L C
• Micaelyn Luree Montgomery, MS CCC-SLP
• Donna Michelle Morey, PHARMACIST
• Helya Najafi-Anaraki, DMD
• Tyler Owens, DMD
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozarks New Hope, Inc.

• Skilled Nursing Facility in Webb City, MO
• Providers in Webb City, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.