Alvia J Carroll
Individual provider Active NPI Home Health Aide · Black Jack, MO
NPI 1477093631 · NPPES record last updated Mar 6, 2017
Key facts
- NPI
- 1477093631
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- License
- 16073 (MO)
- Practice address
- 12632 Broadridge LN
Black Jack, MO 63033-4604 - Phone
- (314) 540-5238
- NPI assigned
- Mar 6, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16073 | MO | MD | Home Health Aide |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Living Waters CDS, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 16073 | MO | Yes |
Addresses
Primary practice location
12632 Broadridge LN
Black Jack, MO 63033-4604
Mailing address
12632 Broadridge LN
Black Jack, MO 63033-4604
Phone (314) 540-5238
Other providers in Black Jack, MO
- Brownstone Healthcare LLC
- Building Bonds Home Health Care LLC
- Dr. Darryl Eugene Calmese Sr.
- Caregivers Unlimited LLC
- Caring Moments in-Home Health LLC
- Charity'S Home Health Care Avency, Inc
- Chestnut Health of Missouri LLC
- Comfort Solutions Health Services LLC
- Daisys Heart Home Healthcare LLC
- Veola Davis
All providers in Black Jack, MO · Home Health Aide in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.