NPIMap

Organization Active NPI

Bristol Care, Inc.

  • Assisted Living Facility
  • Montgomery City, MO
National Provider Identifier
1174739031
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
BRISTOL CARE, INC.
Practice address
625 W 2ND St
Montgomery City, MO 63361-1762
Phone
(573) 564-3386
Fax
(573) 564-3386
NPI assigned
May 15, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Shelley D Ebelling
Title
Medicaid Billing Department
Phone
(660) 826-0200

Corporate family (same tax ID) 22

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

National Provider Directory
Tax ID family
Bristol Care Inc (62 organizations share this tax ID)

Locations

625 W 2nd St
Montgomery City, MO 63361
Phone (573) 564-3386

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

NPPES NPI Registry

Primary practice location

625 W 2ND St
Montgomery City, MO 63361-1762

Mailing address

201 W 3Rd St
Sedalia, MO 65301-4352
Phone (660) 826-0200

Other names 1

NPPES NPI Registry
  • Ashbury Heights of Montgomery City Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 2, 2007.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1174739031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W 3RD ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653014352",
            "telephone_number": "660-826-0200",
            "fax_number": "660-827-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W 2ND ST",
            "city": "MONTGOMERY CITY",
            "state": "MO",
            "postal_code": "633611762",
            "telephone_number": "573-564-3386",
            "fax_number": "573-564-3386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "EBELLING",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAID BILLING DEPARTMENT",
        "authorized_official_telephone_number": "660-826-0200"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ashbury Heights of Montgomery City",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Montgomery City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.