KRC 1495 Health Care Services LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

041597 Issued in MO

Legal business name

KRC 1495 HEALTH CARE SERVICES LLC

Practice address

1495 E Ashland St
Nevada, MO 64772-4016

Phone

(417) 667-5000

NPI assigned

Jan 13, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Karen Clark

Title

Managing Member

Phone

(417) 667-5000

Specialties & licenses 1

Addresses

Other names 1

• Joe Clark Residential Care Home Doing business as

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1316369192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 246",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647720246",
            "telephone_number": "417-667-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 E ASHLAND ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647724016",
            "telephone_number": "417-667-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRC 1495 HEALTH CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-13",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "417-667-5000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "041597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joe Clark Residential Care Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Russell Richard Kemm, D.O.
• Elaine Kirby, LPC
• Samantha Jean Knapp
• Tiffini Alexandra Knedgen, LPC
• William R. Koons, B.C. H.I.S.
• KRC 1505 Health Care Services LLC
• Renee Kurdi, MA
• Kurtz Chiropractic Office, LLC
• Gary A. Kurtz, D.C.
• Chelsay Langford, FNP

• Assisted Living Facility in Nevada, MO
• Providers in Nevada, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.