NPIMap

Organization Active NPI

Neighborhood LTC Pharmacy Inc.

Doing business as Neighborhood LTC Pharmacy

  • Long Term Care Pharmacy
  • Blue Springs, MO
National Provider Identifier
1194339515
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
NEIGHBORHOOD LTC PHARMACY INC.
Doing business as
Neighborhood LTC Pharmacy
Practice address
2525 NW South Outer Rd Ste D
Blue Springs, MO 64015-1726
Phone
(402) 802-4874
NPI assigned
Sep 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Authorized official

Name
Marissa McMahon
Title
Coo
Phone
(402) 488-1184

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Long Term Care Pharmacy 3336L0003X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

2525 NW South Outer Rd Ste D
Blue Springs, MO 64015-1726

Mailing address

1265 S Cotner Blvd Ste 30
Lincoln, NE 68510-4924
Phone (402) 488-1184

Other identifiers 3

IdentifierTypeStateIssuer
201092580AMedicaidOK
30004636200002MedicaidKS
600091856MedicaidMO

Other names 1

  • Neighborhood LTC Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220831001243 MO DME Supplier - Pharmacy 8628290673 Practice locations: Blue Springs, MO
O20240820000383 MO Part B Supplier - Pharmacy 8628290673 2 other NPIs on this enrollment
Practice locations: Columbia, MO; Saint Louis, MO; Blue Springs, MO

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Neighborhood LTC Pharmacy2525 NW South Outer Rd, Blue Springs, MO 64015-1726(816) 256-8878 Nebulizer Drugs Accepts assignmentParticipating since Dec 21, 2020

National Provider Directory

National Provider Directory
Tax ID family
Neighborhood LTC Pharm Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

4240 Blue Ridge Blvd
Ste 100
Kansas City, MO 64133
Phone (816) 256-8878

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1194339515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 S COTNER BLVD STE 30",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104924",
            "telephone_number": "402-488-1184",
            "fax_number": "402-488-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NW SOUTH OUTER RD STE D",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640151726",
            "telephone_number": "402-802-4874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD LTC PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-02",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "MCMAHON",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "402-488-1184"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201092580A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30004636200002",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600091856",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neighborhood LTC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Neighborhood LTC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blue Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.