KRC 1505 Health Care Services LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

041595 Issued in MO

Legal business name

KRC 1505 HEALTH CARE SERVICES LLC

Practice address

1505 East Ashland Street
Nevada, MO 64772

Phone

(417) 667-3900

Fax

(417) 667-3923

NPI assigned

Jan 15, 2014

Organization subpart

No

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

Authorized official

Name

Karen Clark

Title

Managing Member

Phone

(417) 667-3900

Specialties & licenses 1

Addresses

Other names 1

• Clark Care Center - One Doing business as

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1477975183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 E ASHLAND ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647724025",
            "telephone_number": "417-667-3900",
            "fax_number": "417-667-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 EAST ASHLAND STREET",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "64772",
            "telephone_number": "417-667-3900",
            "fax_number": "417-667-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRC 1505 HEALTH CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "417-667-3900"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "041595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark Care Center - One",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elaine Kirby, LPC
• Samantha Jean Knapp
• Tiffini Alexandra Knedgen, LPC
• William R. Koons, B.C. H.I.S.
• KRC 1495 Health Care Services LLC
• Renee Kurdi, MA
• Kurtz Chiropractic Office, LLC
• Gary A. Kurtz, D.C.
• Chelsay Langford, FNP
• Sharon West Lansing, PH.D.

• Assisted Living Facility in Nevada, MO
• Providers in Nevada, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.