NPIMap

Organization Active NPI

Crystal Oaks Long Term Care

Doing business as Crystal Oaks

  • Skilled Nursing Facility
  • Festus, MO
National Provider Identifier
1467592618
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
040114 Issued in MO
Legal business name
CRYSTAL OAKS LONG TERM CARE
Doing business as
Crystal Oaks
Practice address
1500 Calvary Church Rd
Festus, MO 63028-4125
Phone
(636) 933-1818
Fax
(636) 933-1894
NPI assigned
Feb 7, 2007
Last updated
Mar 6, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Authorized official

Name
James V Arnold Jr.
Title
President & Ceo
Phone
(636) 933-1897

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 040114 MO Primary

Addresses

Primary practice location

1500 Calvary Church Rd
Festus, MO 63028-4125

Mailing address

PO Box 680
Crystal City, MO 63019-0680
Phone (636) 933-1818

Other identifiers 1

IdentifierTypeStateIssuer
107808909MedicaidMO

Other names 1

  • Crystal Oaks Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394064000000",
    "number": "1467592618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 680",
            "city": "CRYSTAL CITY",
            "state": "MO",
            "postal_code": "630190680",
            "telephone_number": "636-933-1818",
            "fax_number": "636-933-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CALVARY CHURCH RD",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284125",
            "telephone_number": "636-933-1818",
            "fax_number": "636-933-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL OAKS LONG TERM CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2014-03-06",
        "status": "A",
        "authorized_official_last_name": "ARNOLD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "636-933-1897",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "040114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107808909",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crystal Oaks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; 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.