Organization Active NPI

Kathy Laoma Wilson

  • Nursing Care Agency
  • Doniphan, MO
National Provider Identifier
1124151527
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
Legal business name
KATHY LAOMA WILSON
Practice address
104 C Washington Street
Doniphan, MO 63935-1780
Phone
(573) 996-2770
Fax
(573) 996-4233
NPI assigned
Mar 14, 2007
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. Kathy Laoma Wilson
Title
Owner
Phone
(573) 996-2770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X Primary

Addresses

Primary practice location

104 C Washington Street
Doniphan, MO 63935-1780

Mailing address

104 C Washington Street
Doniphan, MO 63935-1780
Phone (573) 996-2770

Other identifiers 1

IdentifierTypeStateIssuer
0008057MedicaidMO

Other names 1

  • River Valley In Home Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kathy Laoma Wilson2 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": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124151527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 C WASHINGTON STREET",
            "city": "DONIPHAN",
            "state": "MO",
            "postal_code": "639351780",
            "telephone_number": "573-996-2770",
            "fax_number": "573-996-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 C WASHINGTON STREET",
            "city": "DONIPHAN",
            "state": "MO",
            "postal_code": "639351780",
            "telephone_number": "573-996-2770",
            "fax_number": "573-996-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHY LAOMA WILSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "LAOMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-996-2770",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008057",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Valley In Home Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Doniphan, 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.