Organization Active NPI

Director

  • Home Health Agency
  • Saint Louis, MO
National Provider Identifier
1275956286
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
DIRECTOR
Practice address
625 N Euclid Ave Ste 302
Saint Louis, MO 63108-1690
Phone
(314) 825-2084
NPI assigned
Jan 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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

Authorized official

Name
Marcus DickinsonNPI 1023431780
Title
Director/Coordinator
Phone
(314) 825-2084

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

625 N Euclid Ave Ste 302
Saint Louis, MO 63108-1690

Mailing address

1112 Wild Plum Dr
Saint Peters, MO 63303-1208

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390780800000",
    "number": "1275956286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 WILD PLUM DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633031208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N EUCLID AVE STE 302",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081690",
            "telephone_number": "314-825-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECTOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-27",
        "last_updated": "2014-01-27",
        "status": "A",
        "authorized_official_last_name": "DICKINSON",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_title_or_position": "DIRECTOR/COORDINATOR",
        "authorized_official_telephone_number": "314-825-2084"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.