NPIMap

Organization Active NPI

Pony Bird Incorporated

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Mapaville, MO
National Provider Identifier
1114044815
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
1351-8421 Issued in MO
Legal business name
PONY BIRD INCORPORATED
Practice address
#1 Pony Bird Lane
Mapaville, MO 63065-0190
Phone
(636) 931-5818
Fax
(636) 931-3518
NPI assigned
Mar 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Linda M Dallas, BSN, MAHSM
Title
Executive Director
Phone
(636) 931-5818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 1351-8421 MO Primary

Addresses

Primary practice location

#1 Pony Bird Lane
Mapaville, MO 63065-0190

Mailing address

PO Box 190
Mapaville, MO 63065-0190
Phone (636) 931-5818

National Provider Directory

National Provider Directory
Tax ID family
Pony Bird Incorporated4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114044815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "MAPAVILLE",
            "state": "MO",
            "postal_code": "630650190",
            "telephone_number": "636-931-5818",
            "fax_number": "636-931-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#1 PONY BIRD LANE",
            "city": "MAPAVILLE",
            "state": "MO",
            "postal_code": "630650190",
            "telephone_number": "636-931-5818",
            "fax_number": "636-931-3518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONY BIRD INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DALLAS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "636-931-5818",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSN, MAHSM"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "1351-8421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mapaville, 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.

Verify at the official NPI Registry.