Active NPI
Seniortrust of Charlevoix, LLC
- Skilled Nursing Facility
- Saint Charles, MO
National Provider Identifier
1093760886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 031526
- Legal business name
- SENIORTRUST OF CHARLEVOIX, LLC
- Practice address
- 1221 Boones Lick Rd
Saint Charles, MO 63301-2328 - Phone
- (636) 946-6140
- NPI assigned
- May 23, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert Webb
- Title
- President
- Phone
- (615) 893-2749
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 031526 | MO | Primary |
Addresses
Primary practice location
1221 Boones Lick Rd
Saint Charles, MO 63301-2328
Mailing address
1221 Boones Lick Rd
Saint Charles, MO 63301-2328
Phone (636) 946-6140
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 155063 | Other | MO | BC BS MO |
| 229216 | Other | GHP ADVANTRA | |
| 265160 | Other | MERCY | |
| 7100076 | Other | UNITED HEALTH CARE |
National Provider Directory
National Provider Directory- Tax ID family
- Esolutions Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Lewis & Clark Gardens
- Skilled Nursing Facility
- Saint Charles, MO
- NPI 1780923318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1093760886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 BOONES LICK RD",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633012328",
"telephone_number": "636-946-6140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 BOONES LICK RD",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633012328",
"telephone_number": "636-946-6140"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SENIORTRUST OF CHARLEVOIX, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-23",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "WEBB",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "615-893-2749"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MO",
"license": "031526",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS MO",
"identifier": "155063",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP ADVANTRA",
"identifier": "229216",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY",
"identifier": "265160",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "7100076",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.