Healthback Home Health of Missouri, Inc.
Organization Active NPI Home Health Agency · Independence, MO
NPI 1144463266 · NPPES record last updated Sep 9, 2021
Key facts
- NPI
- 1144463266
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 587-11HH (MO)
- Legal business name
- HEALTHBACK HOME HEALTH OF MISSOURI, INC.
- Practice address
- 1520 E 23Rd St
Suite R
Independence, MO 64055-1600 - Phone
- (816) 350-2600
- Fax
- (816) 350-2865
- NPI assigned
- Apr 20, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Troy L. Ayers
- Title
- Chief Financial Officer
- Phone
- (405) 842-1700
Change of ownership 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Sep 9, 2022 | Change of Ownership |
Traditions Health |
National Provider Directory
Locations
4201 S Hocker Dr
Ste 310
Independence, MO 64055
Phone (816) 350-2600
1531 W 32nd St
Ste 204
Joplin, MO 64804
Phone (417) 782-7500
16211 N May Ave
Edmond, OK 73013
Phone (405) 842-1700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 587-11HH | MO | Yes |
Addresses
Primary practice location
1520 E 23Rd St
Suite R
Independence, MO 64055-1600
Mailing address
16211 N May Ave
Edmond, OK 73013-8871
Phone (405) 842-1700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 588675702 | Medicaid | MO |
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All providers in Independence, MO · Home Health Agency in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.