Active NPI
Kathy Laoma Wilson
- Nursing Care Agency
- Doniphan, MO
National Provider Identifier
1124151527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0008057 | Medicaid | MO |
Other names 1
- River Valley In Home Services
National Provider Directory
National Provider Directory- Tax ID family
- Kathy Laoma Wilson
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Nursing Care Agency
- Doniphan, MO
- NPI 1346462918
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.