NPIMap

Organization Active NPI

Knox County Nursing Home District

  • Assisted Living Facility
  • Edina, MO
National Provider Identifier
1215928130
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
030962 Issued in MO
Legal business name
KNOX COUNTY NURSING HOME DISTRICT
Practice address
RR 3 Box 53
Edina, MO 63537-9677
Phone
(660) 397-2282
Fax
(660) 397-2284
NPI assigned
Oct 31, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tim Schrage
Title
Administrator
Phone
(660) 397-2282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 030962 MO Primary

Addresses

Primary practice location

RR 3 Box 53
Edina, MO 63537-9677

Mailing address

RR 3 Box 53
Edina, MO 63537-9677
Phone (660) 397-2282

Other names 1

  • KNOX COUNTY RESIDENTIAL CARE FACILITY Other name

National Provider Directory

National Provider Directory
Tax ID family
Knox County Nursing Home District2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215928130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 53",
            "city": "EDINA",
            "state": "MO",
            "postal_code": "635379677",
            "telephone_number": "660-397-2282",
            "fax_number": "660-397-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 53",
            "city": "EDINA",
            "state": "MO",
            "postal_code": "635379677",
            "telephone_number": "660-397-2282",
            "fax_number": "660-397-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOX COUNTY NURSING HOME DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHRAGE",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "660-397-2282"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "030962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KNOX COUNTY RESIDENTIAL CARE FACILITY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Edina, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.