NPIMap

Organization Active NPI

Peters Agency Home Care, LLC

  • In Home Supportive Care Agency
  • Sallisaw, OK
National Provider Identifier
1245568070
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
7891 Issued in OK
Legal business name
PETERS AGENCY HOME CARE, LLC
Practice address
1015 East Choctaw Avenue
Sallisaw, OK 74955-5011
Phone
(918) 790-7555
Fax
(918) 790-7587
NPI assigned
Dec 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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

Authorized official

Name
Mrs. Trudy A Peters, MBA, RN, CCM, LHCA
Title
Ceo
Phone
(918) 775-6555

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 7891 OK
In Home Supportive Care Agency 253Z00000X 7891 OK Primary
Personal Care AttendantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 3747P1801X 7891 OK
HomemakerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 376J00000X 7891 OK

Addresses

Primary practice location

1015 East Choctaw Avenue
Sallisaw, OK 74955-5011

Mailing address

1015 East Choctaw Avenue
Sallisaw, OK 74955-5011
Phone (918) 790-7555

Other identifiers 1

IdentifierTypeStateIssuer
200202440MedicaidOK

Other names 1

  • Peters Agency Provider Services, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Peters Agency Home Care LLC2 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.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276128000000",
    "number": "1245568070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 EAST CHOCTAW AVENUE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749555011",
            "telephone_number": "918-790-7555",
            "fax_number": "918-790-7587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 EAST CHOCTAW AVENUE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749555011",
            "telephone_number": "918-790-7555",
            "fax_number": "918-790-7587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERS AGENCY HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-07",
        "last_updated": "2010-06-10",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "TRUDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-775-6555",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA, RN, CCM, LHCA"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "OK",
            "license": "7891",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OK",
            "license": "7891",
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "OK",
            "license": "7891",
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": "OK",
            "license": "7891",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200202440",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peters Agency Provider Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sallisaw, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; 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.