Active NPI
Myrtle Evelyn Rigel, BSW
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Koshkonong, MO
National Provider Identifier
1053510925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Practice address
- 320 State Route F
Koshkonong, MO 65692-9206 - Phone
- (417) 867-1227
- NPI assigned
- Jul 12, 2007
- Last updated
- Sep 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | NU | ||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | NU | Primary | |
| Personal Care Attendant | 3747P1801X | NU | ||
| Respite Care | 385H00000X | NU |
Addresses
Primary practice location
320 State Route F
Koshkonong, MO 65692-9206
Mailing address
Route 2
Box 154
Koshkonong, MO 65692
Phone (417) 867-1227
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 856321104 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189641600000",
"number": "1053510925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ROUTE 2",
"address_2": "BOX 154",
"city": "KOSHKONONG",
"state": "MO",
"postal_code": "65692",
"telephone_number": "417-867-1227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 STATE ROUTE F",
"city": "KOSHKONONG",
"state": "MO",
"postal_code": "656929206",
"telephone_number": "417-867-1227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIGEL",
"first_name": "MYRTLE",
"middle_name": "EVELYN",
"name_prefix": "Mrs.",
"credential": "BSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-12",
"last_updated": "2007-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "856321104",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Koshkonong, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.