Missouri Sprout MC 1 LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

MISSOURI SPROUT MC 1 LLC

Practice address

1828 Walnut St FL 3
Kansas City, MO 64108-1835

Phone

(816) 307-1677

NPI assigned

Mar 31, 2020

Organization subpart

No

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

Authorized official

Name

Yury Yakubchyk Sr., MD

Title

Owner

Phone

(816) 307-1677

Specialties & licenses 1

Addresses

Other names 1

• Elemy Doing business as

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636070400000",
    "number": "1104454669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 WALNUT ST FL 3",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641081835",
            "telephone_number": "816-307-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 WALNUT ST FL 3",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641081835",
            "telephone_number": "816-307-1677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7777 Bonhomme Ave",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "MO",
            "postal_code": "631051911",
            "country_code": "US",
            "telephone_number": "816-307-1677",
            "fax_number": "929-384-7193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MISSOURI SPROUT MC 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-31",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A",
        "authorized_official_last_name": "YAKUBCHYK",
        "authorized_official_first_name": "YURY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-307-1677",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elemy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Missouri Hospice Holdings, LLC
• Missouri Intensivist Services LLC
• Missouri Lions Eye Research Foundation
• Missouri Phlebology Inc
• Missouri Professional Medical Services LLC
• Missouri Telerad LLC
• Missouri Valley Therapy Company, LLC
• Mitchell Love Healthcare Services
• Andre L Mitchell, MD
• Braylen Ashli Mitchell

• Behavior Analyst in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.