The Shade Tree LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

THE SHADE TREE LLC

Practice address

1325 S Highland CT
Marshall, MO 65340-3058

Phone

(636) 358-1889

NPI assigned

Mar 4, 2021

Organization subpart

No

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

Authorized official

Name

Kahla Burge, RN BSN

Title

Owner

Phone

(636) 358-1889

Specialties & licenses 1

Addresses

Other names 1

• The Shade Tree Doing business as

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1033704754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4",
            "city": "ARROW ROCK",
            "state": "MO",
            "postal_code": "653200004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S HIGHLAND CT",
            "city": "MARSHALL",
            "state": "MO",
            "postal_code": "653403058",
            "telephone_number": "636-358-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SHADE TREE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "BURGE",
        "authorized_official_first_name": "KAHLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-358-1889",
        "authorized_official_credential": "RN BSN"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Shade Tree",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Stockman, LPN
• Dennis R. Straub
• Summers Pharmacy of Marshall, LLC
• Summers Pharmacy of Marshall, LLC
• The Farris Corporation
• Kaitlin Thiel, MS RDN LD
• Lance Koltyn Thomas, DC
• Cheryl A Thompson, M.D.
• Morgan Michelle Thompson, MOT, OTR/L
• Paul Vincent Thompson, D.D.S.

• Custodial Care Facility in Marshall, MO
• Providers in Marshall, MO by specialty
• Custodial Care Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.