Mba CDS Services LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

6448 Issued in MO

Legal business name

MBA CDS SERVICES LLC

Practice address

613 Davis Blvd
Sikeston, MO 63801-1958

Phone

(573) 481-1088

Fax

(573) 355-5925

NPI assigned

May 11, 2017

Organization subpart

No

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

Authorized official

Name

Miss Rhonda L Williams, MASTER'S OF ARTS

Title

Owner/CDS Coordinator

Phone

(573) 380-0685

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629417600000",
    "number": "1831625771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1386",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638011386",
            "telephone_number": "573-481-1088",
            "fax_number": "573-355-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 DAVIS BLVD",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638011958",
            "telephone_number": "573-481-1088",
            "fax_number": "573-355-5925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Vandiver Dr Ste F",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652023915",
            "country_code": "US",
            "telephone_number": "573-615-1220",
            "fax_number": "573-355-5925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MBA CDS SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/CDS COORDINATOR",
        "authorized_official_telephone_number": "573-380-0685",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MASTER'S OF ARTS"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MO",
            "license": "6448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYEE IDENTIFICATION NUMBER",
            "identifier": "23238011",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stefanie Paige Mason, RN
• Jenny Massey, DPT
• Michelle Renee Masters, COTA
• Fallan Nichole Mayabb, M.D.
• Trevin Mayabb, M.D.
• Mba in-Home Service LLC
• Mba in-Home Services LLC
• Hayley Bernice McCollum, LPC, CRC, NCC
• Ron McCormick Jr.
• Alana Michele McCoy, FNP-C

• Exclusive Provider Organization in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Exclusive Provider Organization in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.