Adams Street Place, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

033716 Issued in MO

Legal business name

ADAMS STREET PLACE, INC.

Practice address

1024 Adams St
Jefferson City, MO 65101-3408

Phone

(573) 635-1320

Fax

(573) 634-3944

NPI assigned

Feb 1, 2007

Last updated

Aug 22, 2020By 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

Mr. Earl E. Carlson Jr.

Title

President

Phone

(573) 635-1320

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245378371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 ADAMS ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013408",
            "telephone_number": "573-635-1320",
            "fax_number": "573-634-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 ADAMS ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013408",
            "telephone_number": "573-635-1320",
            "fax_number": "573-634-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADAMS STREET PLACE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-635-1320",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "033716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Skilled Nursing Facility in Missouri

• 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.