Cedar Knoll Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CEDAR KNOLL HOME

Practice address

13635 State Route V
Saint James, MO 65559-8331

Phone

(573) 265-3658

Fax

(573) 265-3658

NPI assigned

Dec 29, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Susan Staples

Title

Administrator

Phone

(573) 265-3658

Specialties & licenses 1

Addresses

Other names 1

• Cedar KnollRCF II Other name

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104982545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13635 STATE ROUTE V",
            "city": "SAINT JAMES",
            "state": "MO",
            "postal_code": "655598331",
            "telephone_number": "573-265-3658",
            "fax_number": "573-265-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13635 STATE ROUTE V",
            "city": "SAINT JAMES",
            "state": "MO",
            "postal_code": "655598331",
            "telephone_number": "573-265-3658",
            "fax_number": "573-265-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR KNOLL HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STAPLES",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-265-3658",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar KnollRCF II",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kerry Dean Branum, L.P.C.
• Linda Denise Branum, L.P.C.
• Nancy S. Brown, FNP
• Erik Rich Carroll
• Carley Jo Casey, LMSW, MPH
• Jesse David Chandler
• Laura Jean Chilton
• Robin Charee Christopher, LMFT
• Janna L. Clark Roselius, MA, LPC
• Miranda Clark, DOULA

• Assisted Living Facility in Saint James, MO
• Providers in Saint James, MO by specialty
• Assisted Living Facility in Missouri

• 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.

Verify at the official NPI Registry.