NPIMap

Organization Active NPI

Shannon County Health Center

  • In Home Supportive Care Agency
  • Eminence, MO
National Provider Identifier
1104956820
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
SHANNON COUNTY HEALTH CENTER
Practice address
18018 Grey Jones Drive
Eminence, MO 65466
Phone
(573) 226-3914
Fax
(573) 226-3240
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Authorized official

Name
Kandra Counts
Title
Administrator
Phone
(573) 226-3914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

18018 Grey Jones Drive
Eminence, MO 65466

Mailing address

PO Box 788
Eminence, MO 65466-0788
Phone (573) 226-3914

Other identifiers 1

IdentifierTypeStateIssuer
280563404MedicaidMO

Other names 1

  • Shannon County Home Health Agency Other name

National Provider Directory

National Provider Directory
Tax ID family
Shannon County Health Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536537600000",
    "number": "1104956820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "EMINENCE",
            "state": "MO",
            "postal_code": "654660788",
            "telephone_number": "573-226-3914",
            "fax_number": "573-226-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18018 GREY JONES DRIVE",
            "city": "EMINENCE",
            "state": "MO",
            "postal_code": "65466",
            "telephone_number": "573-226-3914",
            "fax_number": "573-226-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON COUNTY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2018-09-10",
        "status": "A",
        "authorized_official_last_name": "COUNTS",
        "authorized_official_first_name": "KANDRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-226-3914"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280563404",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shannon County Home Health Agency",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Shannon County Home Health Agency",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eminence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.