CROSS TRAILS MEDICAL CENTER
NPI 1972925444
Dentist - General Practice in Perryville, MO

NPI Status: Active since January 17, 2014

Contact Information

1314 BRENDA AVE
PERRYVILLE, MO
ZIP 63775
Phone: (573) 332-0808
Fax: (573) 339-7945

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  • Organization
  • Dentist
  • General Practice
  • Accepts Insurance
  • CLIA Number: 26D0931072
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-14-2027

About CROSS TRAILS MEDICAL CENTER

This page provides the complete NPI Profile along with additional information for Cross Trails Medical Center, a provider established in Perryville, Missouri operating as a Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1972925444 assigned on January 2014. The practitioner's primary taxonomy code is 1223G0001X. The provider is registered as an organization and their NPI record was last updated 12 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mona Wells (Cfo)

NPI
1972925444
Provider Name
CROSS TRAILS MEDICAL CENTER
Entity Type
Organization
Location Address
1314 BRENDA AVE PERRYVILLE, MO 63775
Location Phone
(573) 332-0808
Location Fax
(573) 339-7945
Mailing Address
1314 BRENDA AVE PERRYVILLE, MO 63775
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-17-2014
Last Update Date
01-17-2014
Code Navigator

A dentist like Cross Trails Medical Center is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist General Practice

Taxonomy Code
1223G0001X
Type
Dental Providers
Taxonomy Description
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • DentaQuest PPO Pediatric High - PPO
  • DentaQuest PPO Family High - PPO
  • DentaQuest PPO Family Low - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MONA WELLS

Authorized Official Title
CFO
Authorized Official Phone
(573) 339-1196

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
26D0931072
Facility Type
Physician Office
Certificate Effective Date
December 15, 2025
Certificate Expiration Date
December 14, 2027
Laboratory Director
CURTIS L. JANSEN
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Cross Trails Medical Center after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1972925444, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
2
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
2
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
4
Unchanged
Pos 9
4
Doubled → 8
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 9 → 18 → 9 5 → 10 → 1 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 1 + 4 + 2 + 1 + 8 + 2 + 1 + 0 + 4 + 8 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1972925444.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Dentist
1314 BRENDA AVE
PERRYVILLE, MO 63775
Dental Hygienist
1314 BRENDA AVE
PERRYVILLE, MO 63775
Nurse Practitioner (Family)
1314 BRENDA AVE
PERRYVILLE, MO 63775
Clinic/Center (Federally Qualified Health Center (FQHC))
1314 BRENDA AVE
PERRYVILLE, MO 63775

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1972925444, enumerated as an "organization" on January 17, 2014.

The provider is located at 1314 BRENDA AVE PERRYVILLE, MO 63775 and the phone number is (573) 332-0808.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.

The provider might be accepting Accepts: DentaQuest Insurance Company-MO. Please consult your insurance carrier or call the provider to verify.