Polaris Home Health Care St Louis LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

POLARIS HOME HEALTH CARE ST LOUIS LLC

Practice address

13995 Clayton Rd Ste 100
Town and Country, MO 63017-8400

Phone

(516) 727-1634

NPI assigned

Jan 21, 2022

Organization subpart

No

Name

Samuel Goldner

Title

Authorized Person

Phone

(516) 727-1634

Locations

• Aevitas Home Health of St Louis Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 16, 2022.

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1013669944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 CHESTNUT ST STE 102",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162223",
            "telephone_number": "516-727-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13995 CLAYTON RD STE 100",
            "city": "TOWN AND COUNTRY",
            "state": "MO",
            "postal_code": "630178400",
            "telephone_number": "516-727-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLARIS HOME HEALTH CARE ST LOUIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "GOLDNER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "AUTHORIZED PERSON",
        "authorized_official_telephone_number": "516-727-1634"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aevitas Home Health of St Louis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Lea Nicole O'Donnell, FNP-C
• Lisa Oliver, M. ED, PLCP, NCC
• Richard Thomas Orrick, DMD, MSD
• Stuart Allan Pickens, DDS
• Megan Pierce
• Premier Dialysis of West County, Inc
• Gary Paul Quillen, ANP
• Mark Douglas Ravenscraft, MD
• Lindsey Redfield, RN
• Brian Richter, PHD

• All providers in Town and Country, MO
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.