Organization Active NPI

Saint. Mary'S Complete Home Care, LLC

  • In Home Supportive Care Agency
  • Saint Louis, MO
National Provider Identifier
1417533803
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
SAINT. MARY'S COMPLETE HOME CARE, LLC
Practice address
11628 Old Ballas Rd Ste 220
Saint Louis, MO 63141-7030
Phone
(314) 632-6839
NPI assigned
Mar 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Authorized official

Name
Mrs. Mary Enyonam Anyimadu, RNNPI 1881218865
Title
Director of Nursing
Phone
(131) 463-2683

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
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

11628 Old Ballas Rd Ste 220
Saint Louis, MO 63141-7030

Mailing address

11628 Old Ballas Rd Ste 220
Saint Louis, MO 63141-7030
Phone (314) 632-6839

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": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1417533803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11628 OLD BALLAS RD STE 220",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417030",
            "telephone_number": "314-632-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11628 OLD BALLAS RD STE 220",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417030",
            "telephone_number": "314-632-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT. MARY'S COMPLETE HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "ANYIMADU",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ENYONAM",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "131-463-2683",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 24, 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.