NPIMap

Organization Active NPI

My Destinee Home Health, LLC

  • Home Health Agency
  • Saint Louis, MO
National Provider Identifier
1417426156
Registry record updated Nov 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MY DESTINEE HOME HEALTH, LLC
Practice address
2836 Ohio Ave Apt a
Saint Louis, MO 63118-1516
Phone
(314) 625-7233
Fax
(314) 528-5294
NPI assigned
Nov 23, 2018
Last updated
Nov 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2018

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

Authorized official

Name
Ms. Jerr'Ka McCauley
Title
Ceo
Phone
(314) 625-7233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

2836 Ohio Ave Apt a
Saint Louis, MO 63118-1516

Mailing address

2836 Ohio Ave Apt a
Saint Louis, MO 63118-1516
Phone (314) 625-7233

Other identifiers 1

IdentifierTypeStateIssuer
T1019MedicaidMO

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1542931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542931200000",
    "number": "1417426156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2836 OHIO AVE APT A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631181516",
            "telephone_number": "314-625-7233",
            "fax_number": "314-528-5294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2836 OHIO AVE APT A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631181516",
            "telephone_number": "314-625-7233",
            "fax_number": "314-528-5294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY DESTINEE HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-23",
        "last_updated": "2018-11-23",
        "status": "A",
        "authorized_official_last_name": "MCCAULEY",
        "authorized_official_first_name": "JERR'KA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-625-7233",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T1019",
            "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 Nov 23, 2018; 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.