St Charles Health Care LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ST CHARLES HEALTH CARE LLC

Doing business as

Frontier Health & Rehabilitation

Practice address

2840 W Clay St
Saint Charles, MO 63301-2536

Phone

(636) 946-6100

Fax

(636) 940-0998

NPI assigned

Sep 5, 2013

Last updated

May 16, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kam McGavock

Title

President

Phone

(410) 773-1000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Frontier Health & Rehabilitation Doing business as

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400198400000",
    "number": "1306271655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 W CLAY ST",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012536",
            "telephone_number": "636-946-6100",
            "fax_number": "636-940-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CHARLES HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-05",
        "last_updated": "2014-05-16",
        "status": "A",
        "authorized_official_last_name": "MCGAVOCK",
        "authorized_official_first_name": "KAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-773-1000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101484004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Frontier Health & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.