Phoenix Home Care, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PHOENIX HOME CARE, LLC

Practice address

3033 S Kansas Expy
Springfield, MO 65807-5969

Phone

(417) 881-7442

Fax

(417) 889-7442

NPI assigned

Oct 22, 2018

Organization subpart

No

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

Authorized official

Name

George Scott Herman

Title

President & Secretary

Phone

(417) 838-3000

Specialties & licenses 1

Addresses

Other names 1

• Phoenix Home Care and Hospice Doing business as

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1003382680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 N. ROCK RD.",
            "address_2": "#213, ATTN: DEBRA MULLEN",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672261352",
            "telephone_number": "316-688-5511",
            "fax_number": "417-889-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 S KANSAS EXPY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075969",
            "telephone_number": "417-881-7442",
            "fax_number": "417-889-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-22",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT & SECRETARY",
        "authorized_official_telephone_number": "417-838-3000"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Home Care and Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phoenix Home Care and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rex Phipps
• William David Phipps, RPH
• Phoenix Home Care Inc
• Phoenix Home Care Inc
• Phoenix Home Care, Inc.
• Phoenix Home Care, LLC
• Phoenix Home Care, LLC
• Phoenix Home Care, LLC
• Phoenix Home Care, LLC
• Phoenix Home Care, LLC

• All providers in Springfield, MO
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.