Community Care Center of Mark Twain Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

030955 Issued in MO

Legal business name

COMMUNITY CARE CENTER OF MARK TWAIN INC

Practice address

11988 Mark Twain LN
Bridgeton, MO 63044-2825

Phone

(314) 291-8240

Fax

(314) 209-9426

NPI assigned

Sep 2, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Christina M Giardina

Title

President

Phone

(636) 394-3000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mark Twain Manor Doing business as

Practitioners 2

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

• Christopher T. Labonte, MD

  • Internal Medicine Physician
  • Town and Country, MO
  • NPI 1093813099
  NPD (past)
• Manuel Le-Yeng San, D.O.

  • Family Medicine Physician
  • Columbia, MO
  • NPI 1245443548
  NPD (past)

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1790779924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 SOVEREIGN CT",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114432",
            "telephone_number": "636-394-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11988 MARK TWAIN LN",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442825",
            "telephone_number": "314-291-8240",
            "fax_number": "314-209-9426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE CENTER OF MARK TWAIN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-02",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "GIARDINA",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-394-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "030955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101497402",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mark Twain Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mark Twain Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Lee Cogan-Levy, MD
• Kelly Lynn Collora, RPH
• Destinee Colvin, RBT
• Nehemiah Colyer, PT, DPT
• Comfort & Joy Home Health Care Agency
• Community Reach
• Compassionate Care
• Compre Care Medical
• Comprecare Medical, LLC
• Comprehensive Eye Care and Surgery Inc.

• Skilled Nursing Facility in Bridgeton, MO
• Providers in Bridgeton, 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 Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.