Provider Demographics
NPI:1689904336
Name:NEVADA CITY HOSPITAL
Entity Type:Organization
Organization Name:NEVADA CITY HOSPITAL
Other - Org Name:NEVADA REGIONAL MEDICAL CENTER SPECIALTY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-448-3626
Mailing Address - Street 1:800 S. ASH STREET
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-3223
Mailing Address - Country:US
Mailing Address - Phone:417-667-3355
Mailing Address - Fax:417-448-3796
Practice Address - Street 1:800 S. ASH STREET
Practice Address - Street 2:SUITE 210
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-3223
Practice Address - Country:US
Practice Address - Phone:417-448-3603
Practice Address - Fax:417-448-3604
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEVADA CITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-31
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO260061Medicare Oscar/Certification