Covenant Optimized Living LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

112571 Issued in MO

Legal business name

COVENANT OPTIMIZED LIVING LLC

Practice address

4910 Frederick Ave
Saint Joseph, MO 64506-3246

Phone

(816) 233-3700

Fax

(816) 233-3754

NPI assigned

Mar 26, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Kari J Haywood

Title

Billing Manager

Phone

(816) 233-3700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332720000000",
    "number": "1467728303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 FREDERICK AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063246",
            "telephone_number": "816-233-3700",
            "fax_number": "816-233-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 FREDERICK AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063246",
            "telephone_number": "816-233-3700",
            "fax_number": "816-233-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT OPTIMIZED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-26",
        "last_updated": "2012-03-26",
        "status": "A",
        "authorized_official_last_name": "HAYWOOD",
        "authorized_official_first_name": "KARI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "816-233-3700",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "112571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kassidy Ann Courter
• Covenant Care LLC
• Covenant Compassionate Care Inc.
• Covenant Compassionate Care, Inc.
• Covenant in Home Care LLC (Covenant Care)
• Frederick Vincent Covillo, D.O.
• Dorothy Louise Cox, F.N.P.
• Andrea Haydn Coy
• Carissa Janel Crabb, L.C.S.W.
• Mirranda Crane

• Internal Medicine Physician in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.