Sherrods Foster Home and Isl

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

393-6116 Issued in MO

Legal business name

SHERRODS FOSTER HOME AND ISL

Practice address

43654 State Highway 25
Malden, MO 63863-9492

Phone

(573) 276-3640

NPI assigned

Mar 21, 2007

Last updated

Jul 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hester B Handy

Title

Administrativi

Phone

(573) 276-3640

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216598400000",
    "number": "1184740292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43654 STATE HIGHWAY 25",
            "city": "MALDEN",
            "state": "MO",
            "postal_code": "638639492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43654 STATE HIGHWAY 25",
            "city": "MALDEN",
            "state": "MO",
            "postal_code": "638639492",
            "telephone_number": "573-276-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERRODS FOSTER HOME AND ISL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2008-07-21",
        "status": "A",
        "authorized_official_last_name": "HANDY",
        "authorized_official_first_name": "HESTER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ADMINISTRATIVI",
        "authorized_official_telephone_number": "573-276-3640"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "MO",
            "license": "393-6116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "853851400",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeshia Rochelle Robinson
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• Kristen Sitzes
• Stephen A Smith, M.D.
• Roselle Ycu Solijon, OTR
• Southeast Health Center of Stoddard County, LLC (Mercy Hospital Stoddard)
• Southeast Missouri Health Network (Southeast Health on Wheels Mobile Van)

• Preferred Provider Organization in Malden, MO
• Providers in Malden, MO by specialty
• Preferred Provider Organization in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; 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.