Active NPI
Charise Thomas
- Home Health Agency
- Saint Louis, MO
National Provider Identifier
1407371750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- LC001549753
- Practice address
- 5056A Mardel Ave
Saint Louis, MO 63109-1730 - Phone
- (314) 262-1476
- NPI assigned
- Aug 8, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | LC001549753 | MO | Primary |
Addresses
Primary practice location
5056A Mardel Ave
Saint Louis, MO 63109-1730
Mailing address
5056A Mardel Ave
Saint Louis, MO 63109-1730
Phone (314) 262-1476
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 251E00000X | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC001549753 | MO | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1407371750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5056A MARDEL AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631091730",
"telephone_number": "314-262-1476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5056A MARDEL AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631091730",
"telephone_number": "314-262-1476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "CHARISE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-08",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "MO",
"license": "LC001549753",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "251E00000X",
"state": "MO"
}
],
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.