NPIMap

Organization Active NPI

Cross Trails Medical Center

  • General Practice Dentistry
  • Advance, MO
National Provider Identifier
1841508264
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CROSS TRAILS MEDICAL CENTER
Practice address
307 Gabriel St
Advance, MO 63730
Phone
(573) 722-3034
Fax
(573) 722-3244
NPI assigned
Sep 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Authorized official

Name
Mona Wells
Title
Cfo
Phone
(573) 339-1196

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

307 Gabriel St
Advance, MO 63730

Mailing address

307 Gabriel St
Advance, MO 63730
Phone (573) 332-0808

National Provider Directory

National Provider Directory
Tax ID family
Cross Trails Medical Ce9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

307 W Gabriel St
Advance, MO 63730
Phone (573) 332-0808

NPI Registry JSON

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284940800000",
    "number": "1841508264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 GABRIEL ST",
            "city": "ADVANCE",
            "state": "MO",
            "postal_code": "63730",
            "telephone_number": "573-332-0808",
            "fax_number": "573-339-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 GABRIEL ST",
            "city": "ADVANCE",
            "state": "MO",
            "postal_code": "63730",
            "telephone_number": "573-722-3034",
            "fax_number": "573-722-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSS TRAILS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-20",
        "last_updated": "2010-09-20",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-339-1196"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Advance, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.