Sun Lakes Therapy

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2001001805 Issued in MO

Legal business name

SUN LAKES THERAPY

Practice address

21094 Lawrence 2072
Ash Grove, MO 65604

Phone

(417) 773-6388

NPI assigned

Nov 19, 2012

Last updated

Nov 19, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Kristi Jan Haynes, COTA/LNPI 1760063127

Title

Occupational Therapy Assistant

Phone

(417) 773-6388

Specialties & licenses 1

Addresses

Other names 1

• Mt. Vernon Vet Home Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristi Jan Haynes

  • Occupational Therapy Assistant
  • Humansville, MO
  • NPI 1760063127
  NPD (past) Authorized official

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1457695165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21094 LAWRENCE 2072",
            "city": "ASH GROVE",
            "state": "MO",
            "postal_code": "65604",
            "telephone_number": "417-773-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21094 LAWRENCE 2072",
            "city": "ASH GROVE",
            "state": "MO",
            "postal_code": "65604",
            "telephone_number": "417-773-6388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN LAKES THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "JAN",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPY ASSISTANT",
        "authorized_official_telephone_number": "417-773-6388",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "COTA/L"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "2001001805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt. Vernon Vet Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hailey A Lampley
• Rebecca Lynn Loveland, COTA/L
• Moonlight Valley Medical Massage, LLC
• David Rivera Jr.
• Lori Leanne Soper, PTA
• Angela Waterman
• Stiehl C Wilson, B.S., D.C.
• Your Health Consultant
• Samuel Reed Zimmer, DDS

• Skilled Nursing Facility in Ash Grove, MO
• Providers in Ash Grove, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.