NPIMap

Organization Active NPI

Comprehensive Independent Goals Inc St. Louis Consumer Directed Servic

  • In Home Supportive Care Agency
  • Saint Louis, MO
National Provider Identifier
1376802678
Registry record updated May 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
COMPREHENSIVE INDEPENDENT GOALS INC ST. LOUIS CONSUMER DIRECTED SERVIC
Practice address
40 N Kingshighway Blvd
Suite - 6
Saint Louis, MO 63108-1378
Phone
(314) 361-7337
Fax
(314) 361-3361
NPI assigned
May 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2012

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

Authorized official

Name
Mr. Ronnie Max McGowan
Title
Pres./C. F. O.
Phone
(314) 361-7337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

40 N Kingshighway Blvd
Suite - 6
Saint Louis, MO 63108-1378

Mailing address

PO Box 66037
Baton Rouge, LA 70896-6037
Phone (225) 926-5190

Other identifiers 5

IdentifierTypeStateIssuer
1157384MedicaidLA
1173835MedicaidLA
1642649MedicaidLA
1104137041MedicaidMO
1157392MedicaidLA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336435200000",
    "number": "1376802678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66037",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708966037",
            "telephone_number": "225-926-5190",
            "fax_number": "225-926-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 N KINGSHIGHWAY BLVD",
            "address_2": "SUITE - 6",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081378",
            "telephone_number": "314-361-7337",
            "fax_number": "314-361-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE INDEPENDENT GOALS INC ST. LOUIS CONSUMER DIRECTED SERVIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2012-05-08",
        "status": "A",
        "authorized_official_last_name": "MCGOWAN",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_middle_name": "MAX",
        "authorized_official_title_or_position": "PRES./C. F. O.",
        "authorized_official_telephone_number": "314-361-7337",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1157384",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1173835",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1642649",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104137041",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1157392",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; 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.