NPIMap

Organization Active NPI

SB40 TCM

  • Case Management Agency
  • Middle Brook, MO
National Provider Identifier
1043455272
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SB40 TCM
Practice address
HC 1 Box 2
Middle Brook, MO 63656-9701
Phone
(573) 546-3981
NPI assigned
Dec 2, 2008
Last updated
Dec 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Authorized official

Name
Mr. Gary Wayne Phegley
Title
Director
Phone
(573) 546-3981

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Case Management Agency 251B00000X MO Primary

Addresses

Primary practice location

HC 1 Box 2
Middle Brook, MO 63656-9701

Mailing address

PO Box 278
Ironton, MO 63650-0278
Phone (573) 546-3981

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228176000000",
    "number": "1043455272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 278",
            "city": "IRONTON",
            "state": "MO",
            "postal_code": "636500278",
            "telephone_number": "573-546-3981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 2",
            "city": "MIDDLE BROOK",
            "state": "MO",
            "postal_code": "636569701",
            "telephone_number": "573-546-3981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SB40 TCM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-02",
        "last_updated": "2008-12-02",
        "status": "A",
        "authorized_official_last_name": "PHEGLEY",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "573-546-3981",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Brook, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; 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.