Organization Active NPI

Bootheel in-Home Care Services, LLC

  • In Home Supportive Care Agency
  • New Madrid, MO
National Provider Identifier
1285677930
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
BOOTHEEL IN-HOME CARE SERVICES, LLC
Practice address
311 Main St
New Madrid, MO 63869-1942
Phone
(573) 748-5905
Fax
(573) 748-5795
NPI assigned
Jun 13, 2006
Last updated
Jun 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Authorized official

Name
Mrs. Kathey G Verbeck
Title
President
Phone
(618) 616-7732

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X NU
Personal Care Attendant 3747P1801X NU
Homemaker 376J00000X NU
Nurse's Aide 376K00000X NU
Registered Nurse 163W00000X NU
Licensed Practical Nurse 164W00000X NU
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

311 Main St
New Madrid, MO 63869-1942

Mailing address

311 Main St
New Madrid, MO 63869-1942
Phone (573) 748-5905

Other identifiers 1

IdentifierTypeStateIssuer
26-6165208MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Bootheel in-Home Care Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590969600000",
    "number": "1285677930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 MAIN ST",
            "city": "NEW MADRID",
            "state": "MO",
            "postal_code": "638691942",
            "telephone_number": "573-748-5905",
            "fax_number": "573-748-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 MAIN ST",
            "city": "NEW MADRID",
            "state": "MO",
            "postal_code": "638691942",
            "telephone_number": "573-748-5905",
            "fax_number": "573-748-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOTHEEL IN-HOME CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A",
        "authorized_official_last_name": "VERBECK",
        "authorized_official_first_name": "KATHEY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-616-7732",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26-6165208",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Madrid, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.