| Cross Trails Medical Center | |
|
408 S Broadview St Cape Girardeau MO 63703-5725 | |
| (573) 332-0808 | |
| (573) 339-7945 |
| Full Name | Cross Trails Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 408 S Broadview St, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Vicki A Smith (CEO) |
| Authorized Official Contact | 5733391196 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cross Trails Medical Center 408 S Broadview St Cape Girardeau MO 63703-5725 Ph: (573) 332-0808 | Cross Trails Medical Center 408 S Broadview St Cape Girardeau MO 63703-5725 Ph: (573) 332-0808 |
| NPI Number | 1356393268 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 06/26/2008 |
| Medicare PECOS PAC ID | 8820902851 |
|---|---|
| Medicare Enrollment ID | O20031114000205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356393268 | NPI | - | NPPES |
| 508082807 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Sherri L Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639267990 PECOS PAC ID: 2668578378 Enrollment ID: I20070426000070 |
| Provider Name | Karen Tracy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346252293 PECOS PAC ID: 2769381946 Enrollment ID: I20070828000268 |
| Provider Name | Edward J Doyle |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1558362822 PECOS PAC ID: 3173668381 Enrollment ID: I20100226000326 |
| Provider Name | Brenna Maria C Keller |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1932261104 PECOS PAC ID: 7113078361 Enrollment ID: I20121023000587 |
| Provider Name | Amy E Massa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760739668 PECOS PAC ID: 8628228475 Enrollment ID: I20121101000342 |
| Provider Name | Dana M Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760730139 PECOS PAC ID: 2365697786 Enrollment ID: I20130308000219 |
| Provider Name | Jessica Suhre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407125370 PECOS PAC ID: 4284869678 Enrollment ID: I20131018001653 |
| Provider Name | Curtis L Jansen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447530597 PECOS PAC ID: 2466673082 Enrollment ID: I20141024000806 |
| Provider Name | Sarah Goodman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962645838 PECOS PAC ID: 4587813290 Enrollment ID: I20151119002975 |
| Provider Name | Amanda Pleimann-king |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659722155 PECOS PAC ID: 0244522621 Enrollment ID: I20190724000695 |
| Provider Name | Angela Kay Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598316564 PECOS PAC ID: 4688906373 Enrollment ID: I20191030000876 |
| Provider Name | Robert D Anderson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1770698912 PECOS PAC ID: 5698088920 Enrollment ID: I20210708000173 |
| Provider Name | Julia J Lincicum |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1356070890 PECOS PAC ID: 4587045851 Enrollment ID: I20220718002160 |
| Provider Name | Constance R Koerner Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386108181 PECOS PAC ID: 5092170258 Enrollment ID: I20230424001716 |
Johns Healthcare Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 Independence St Ste A, Cape Girardeau, MO 63703 Phone: 573-304-3143 Fax: 573-334-0493 | |
Cross Trails Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2430 Golden Street, Cape Girardeau, MO 63703 Phone: 573-339-1196 Fax: 573-339-9378 | |
Auburn Surgery Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 S Mount Auburn Rd, Ste 200, Cape Girardeau, MO 63703 Phone: 573-332-7881 Fax: 573-651-4431 | |
Midtown Family Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 N Sprigg St, Cape Girardeau, MO 63701 Phone: 573-332-7992 Fax: 573-332-7998 | |
Kenneth A Decoursey, Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1723 Broadway St, Suite 120, Cape Girardeau, MO 63701 Phone: 573-334-7194 Fax: 573-334-4937 | |
Immediate Healthcare, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1702 N Kingshighway St, Cape Girardeau, MO 63701 Phone: 573-339-2000 Fax: 573-339-1876 | |
Immediate Convenient Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1702 N Kingshighway St, Cape Girardeau, MO 63701 Phone: 573-339-2000 |