Charleston Manor Nursing, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

030652 Issued in MO

Legal business name

CHARLESTON MANOR NURSING, LLC

Practice address

1220 E Marshall St
Charleston, MO 63834-1349

Phone

(573) 683-3721

Fax

(573) 683-3029

NPI assigned

Jul 7, 2005

Last updated

Aug 22, 2020By 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

Mr. James Reiker

Title

Treasurer

Phone

(573) 471-1113

Specialties & licenses 1

Addresses

Other names 1

• Charleston Manor Other name

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• R H Montgomery Properties, Inc

  dba The Neighborhoods at Quail Creek

  • Skilled Nursing Facility
  • Springfield, MO
  • NPI 1730292863

  Member Of

  NPD member

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477550259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 E MARSHALL ST",
            "city": "CHARLESTON",
            "state": "MO",
            "postal_code": "638341349",
            "telephone_number": "573-683-3721",
            "fax_number": "573-683-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 E MARSHALL ST",
            "city": "CHARLESTON",
            "state": "MO",
            "postal_code": "638341349",
            "telephone_number": "573-683-3721",
            "fax_number": "573-683-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON MANOR NURSING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REIKER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "573-471-1113",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "030652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charleston Manor",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bio-Medical Applications of Missouri, Inc. (Fresenius Medical Care of Mississippi County)
• C & H Drugs Inc (Simmons & Graham Pharmacy)
• C & H Drugs, Inc. (Simmons & Graham Pharmacy)
• Rebecca Chapman, D.C.
• Charleston Chiropractic LLC
• Charleston R-1 School District
• Tamara Lee Cox, LPC
• Rebecca L Crowley-Kuykendall, RD LD CNSC
• Bianca Daisy
• Amber Nikole Faire, FNP-C

• Skilled Nursing Facility in Charleston, MO
• Providers in Charleston, 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 Aug 22, 2020; 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.