Divine Destiny Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DIVINE DESTINY HOME CARE LLC

Practice address

1809 Vandiver Dr Ste 105
Columbia, MO 65202-3948

Phone

(573) 797-6007

NPI assigned

May 6, 2021

Organization subpart

No

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

Authorized official

Name

Mariah Proctor, OWNERNPI 1164039871

Title

As

Phone

(573) 814-8528

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mariah Proctor

  • Home Health Agency
  • Columbia, MO
  • NPI 1164039871
  NPD Authorized official

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1366026296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 VANDIVER DR STE 105",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652023948",
            "telephone_number": "573-797-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 VANDIVER DR STE 105",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652023948",
            "telephone_number": "573-797-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE DESTINY HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "PROCTOR",
        "authorized_official_first_name": "MARIAH",
        "authorized_official_title_or_position": "AS",
        "authorized_official_telephone_number": "573-814-8528",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Divinedestiny340@yahoo.com",
            "affiliation": "N",
            "address_1": "1809 Vandiver Dr Ste 105",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652023948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James A Direnna, D.O.
• Jack Dirnberger, MD
• Hayley Moore Ditmars, MD
• Stephen E Dittmer, LPC
• Frank Anthony Divincenzo, M.D.
• Cindy Lee Dixon
• Kiera Lexi Dixon, LCSW
• Maurice L Dixon Jr., MA, LPC
• Stephanie L Dixon, MS, LPC
• Trevor L Dixon, MD

• Home Health Agency in Columbia, MO
• Providers in Columbia, MO by specialty
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.