Intrepid of Missouri, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

INTREPID OF MISSOURI, INC.

Doing business as

Intrepid USA Hospice

Practice address

4311 S National Ave
Springfield, MO 65810-2607

Phone

(417) 882-0614

Fax

(417) 823-3071

NPI assigned

Apr 16, 2012

Organization subpart

No

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

Authorized official

Name

John M Kunysz Jr.

Title

Chief Executive Officer

Phone

(214) 445-3750

Specialties & licenses 1

Addresses

Other names 1

• Intrepid USA Hospice Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1245597285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14841 DALLAS PKWY STE 625",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547641",
            "telephone_number": "214-445-3750",
            "fax_number": "214-445-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658102607",
            "telephone_number": "417-882-0614",
            "fax_number": "417-823-3071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3025 S Main St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648042677",
            "country_code": "US",
            "telephone_number": "417-233-4132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTREPID OF MISSOURI, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-16",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "KUNYSZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "214-445-3750",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Intrepid USA Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intrepid USA Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Integrity Home Care, LLC
• Integrity Home Care, LLC
• Integrity Home Care, LLC
• Integrity Hospice of Southwest Missouri, Inc.
• Interlink Behavioral Services, P.C.
• Melody Anne Ipock, PLPC
• Donna Marie Irish, APRN-BC, GNP
• Iron Bridge Diabetes & Endo
• Vanessa Lynne Irons, MA PLPC
• Sarah Grace Irwin, DNP

• Community Based Hospice Care Agency in Springfield, MO
• Providers in Springfield, MO by specialty
• Community Based Hospice Care Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.