NPIMap

Organization Active NPI

Haven Physical Therapy

  • Home Health Agency
  • Ozark, MO
National Provider Identifier
1407396393
Registry record updated Aug 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
RO570 Issued in MO
Legal business name
HAVEN PHYSICAL THERAPY
Practice address
1114 W Jackson St
Ozark, MO 65721-9164
Phone
(417) 581-1234
NPI assigned
Feb 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2017

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

Authorized official

Name
John Ray, PTNPI 1154597524
Title
Ceo
Phone
(417) 581-1234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X RO570 MO Primary

Addresses

Primary practice location

1114 W Jackson St
Ozark, MO 65721-9164

Mailing address

850 N 25TH St
Ozark, MO 65721-9164
Phone (417) 581-1234

Other identifiers 1

IdentifierTypeStateIssuer
1740586940MedicaidMO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501545600000",
    "number": "1407396393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 N 25TH ST",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657219164",
            "telephone_number": "417-581-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 W JACKSON ST",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657219164",
            "telephone_number": "417-581-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-08-01",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-581-1234",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "RO570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740586940",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ozark, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2017; 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.