NPIMap

Organization Active NPI

Fredericktown R-I School Dist

  • Local Education Agency (LEA)
  • Fredericktown, MO
National Provider Identifier
1356481295
Registry record updated Nov 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
Legal business name
FREDERICKTOWN R-I SCHOOL DIST
Practice address
704 E Highway 72
Fredericktown, MO 63645-7491
Phone
(573) 783-2570
Fax
(573) 783-7045
NPI assigned
Feb 8, 2007
Last updated
Nov 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2009

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

Authorized official

Name
Dr. Kelly A Burlison
Title
Superintendent
Phone
(573) 783-2570

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU
Local Education Agency (LEA) 251300000X NU Primary

Addresses

Primary practice location

704 E Highway 72
Fredericktown, MO 63645-7491

Mailing address

704 E Highway 72
Fredericktown, MO 63645-7491
Phone (573) 783-2570

Other identifiers 1

IdentifierTypeStateIssuer
506076207MedicaidMO

National Provider Directory

National Provider Directory

Locations

704 E Highway 72
Fredericktown, MO 63645
Phone (573) 783-2570

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257724800000",
    "number": "1356481295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 E HIGHWAY 72",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "636457491",
            "telephone_number": "573-783-2570",
            "fax_number": "573-783-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 E HIGHWAY 72",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "636457491",
            "telephone_number": "573-783-2570",
            "fax_number": "573-783-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICKTOWN R-I SCHOOL DIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2009-11-09",
        "status": "A",
        "authorized_official_last_name": "BURLISON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "573-783-2570",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506076207",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericktown, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; 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.