Deaconess Long Term Care of Missouri, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

029420 Issued in MO

Legal business name

DEACONESS LONG TERM CARE OF MISSOURI, INC.

Doing business as

Monett Health Care Center

Practice address

410 W Benton St
Monett, MO 65708-1608

Phone

(417) 235-6031

Fax

(417) 235-8676

NPI assigned

Aug 31, 2005

Last updated

Dec 23, 2009By 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

Carla Brooks

Title

Cfo

Phone

(513) 487-3600

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Monett Health Care Center Doing business as

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1114911435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 LAFAYETTE AVE",
            "address_2": "SUITE 400",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452201022",
            "telephone_number": "513-487-3600",
            "fax_number": "513-487-3653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W BENTON ST",
            "city": "MONETT",
            "state": "MO",
            "postal_code": "657081608",
            "telephone_number": "417-235-6031",
            "fax_number": "417-235-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEACONESS LONG TERM CARE OF MISSOURI, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "513-487-3600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "029420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101481208",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5938513",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monett Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cox-Monett Hospital, Inc. (Cox Monett Hospital)
• Creative Arts Therapy Center, Inc. (Creative Therapy Center)
• Sherri Lynn Criqui, LMFT
• Tobin Scott Crow, DO
• Sergio G Cruz, M.D.
• Dr C Bret Bowling M D Independent Specialist of Family Medicine
• Steve Mark Drew, D.O.
• Tanya Marie Duncan, RPH
• Matthew J Dzak, PSYD, HSPP
• Elaine Epp, R.N

• Skilled Nursing Facility in Monett, MO
• Providers in Monett, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.