Linda K Roark

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

CC1-0207-0413 Issued in MO

Practice address

219 W 24TH St
Sedalia, MO 65301-8303

Phone

(660) 826-0244

NPI assigned

Mar 13, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Linda Roark Group Care

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • Sedalia, MO
  • NPI 1225169659
  NPD (past) Authorized official
• Roark Isl

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Sedalia, MO
  • NPI 1285057034

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD (past) Authorized official

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1154747251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27880 HACKBERRY DR",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653010561",
            "telephone_number": "660-826-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 W 24TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653018303",
            "telephone_number": "660-826-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROARK",
        "first_name": "LINDA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-13",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "CC1-0207-0413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "852752203",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rest Haven SNF Opco LLC
• Blaire Riley, LCSW
• Riverside Pediatrics, Inc
• Roark I.S.L.
• Roark Isl
• Ashley R Roberts, PTA
• Terence Alan Robertson, MD
• David H Roehrs, MD
• Scott Taggart Roethle, M.D.
• Connie Sue Rolf, RPH

• All providers in Sedalia, MO
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.