Organization Active NPI

Activangels Home Health

  • Home Health Agency
  • Saint Louis, MO
National Provider Identifier
1114419546
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ACTIVANGELS HOME HEALTH
Practice address
4625 Lindell Blvd Ste 304
Saint Louis, MO 63108
Phone
(314) 374-2094
NPI assigned
Jun 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Authorized official

Name
Keynon Marsh
Title
Owner
Phone
(314) 249-7003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X MO Primary

Addresses

Primary practice location

4625 Lindell Blvd Ste 304
Saint Louis, MO 63108

Mailing address

4625 Lindell Blvd Ste 304
Saint Louis, MO 63108-3729
Phone (314) 374-2094

National Provider Directory

National Provider Directory

Locations

4625 Lindell Blvd
Ste 304
Saint Louis, MO 63108
Phone (314) 374-2094

NPI Registry JSON

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533600000000",
    "number": "1114419546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 LINDELL BLVD STE 304",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631083729",
            "telephone_number": "314-374-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 LINDELL BLVD STE 304",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63108",
            "telephone_number": "314-374-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVANGELS HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-01",
        "last_updated": "2018-08-07",
        "status": "A",
        "authorized_official_last_name": "MARSH",
        "authorized_official_first_name": "KEYNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-249-7003"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.