First Midwest Consumer Directed Services LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

FIRST MIDWEST CONSUMER DIRECTED SERVICES LLC

Practice address

7733 Forsyth Blvd FL 11
Clayton, MO 63105-1878

Phone

(314) 296-6199

Fax

(314) 754-9591

NPI assigned

Mar 4, 2017

Organization subpart

No

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

Authorized official

Name

Derrick R Williams, JD

Title

Executive Director

Phone

(314) 677-0394

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1488585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488585600000",
    "number": "1295275626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7733 FORSYTH BLVD FL 11",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631051878",
            "telephone_number": "314-296-6199",
            "fax_number": "314-754-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7733 FORSYTH BLVD FL 11",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631051878",
            "telephone_number": "314-296-6199",
            "fax_number": "314-754-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST MIDWEST CONSUMER DIRECTED SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-04",
        "last_updated": "2017-03-04",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "314-677-0394",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Devin Edward Fitzgerald, COTA
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• Miguel Prieto Flores, D.C
• Matthew Alan Flory, DC

• In Home Supportive Care Agency in Clayton, MO
• Providers in Clayton, MO by specialty
• In Home Supportive Care Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2017; 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.