Organization Active NPI

Sage Creek LLC

  • Homemaker
  • Malden, MO
National Provider Identifier
1215445630
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
Legal business name
SAGE CREEK LLC
Practice address
101 N Madison
Malden, MO 63863
Phone
(573) 281-2103
Fax
(573) 281-2168
NPI assigned
Jan 19, 2018
Last updated
Oct 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Authorized official

Name
John Welch
Title
Owner
Phone
(573) 276-8916

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X NU
Homemaker 376J00000X NU Primary

Addresses

Primary practice location

101 N Madison
Malden, MO 63863

Mailing address

127 W Main St
Malden, MO 63863-2162
Phone (573) 281-2103

National Provider Directory

National Provider Directory

Locations

101 N Madison St
Malden, MO 63863
Phone (573) 281-2103

127 W Main St
Malden, MO 63863

NPI Registry JSON

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1215445630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W MAIN ST",
            "city": "MALDEN",
            "state": "MO",
            "postal_code": "638632162",
            "telephone_number": "573-281-2103",
            "fax_number": "573-281-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N MADISON",
            "city": "MALDEN",
            "state": "MO",
            "postal_code": "63863",
            "telephone_number": "573-281-2103",
            "fax_number": "573-281-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE CREEK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-19",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-276-8916"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.