NPIMap

Organization Active NPI

Covenant Care Services, LLC

  • Licensed Practical Nurse
  • Fredericktown, MO
National Provider Identifier
1487749537
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
Legal business name
COVENANT CARE SERVICES, LLC
Practice address
120 S. Mine Lamotte
Fredericktown, MO 63645
Phone
(573) 783-6256
Fax
(573) 783-8148
NPI assigned
Oct 4, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Warren Keith Reagan
Title
Member/Manager
Phone
(573) 783-6256

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X
Licensed Practical Nurse 164W00000X Primary

Addresses

Primary practice location

120 S. Mine Lamotte
Fredericktown, MO 63645

Mailing address

120 S. Mine Lamotte
Fredericktown, MO 63645
Phone (573) 783-6256

National Provider Directory

National Provider Directory
Tax ID family
Covenant Care Services LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1487749537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S. MINE LAMOTTE",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "63645",
            "telephone_number": "573-783-6256",
            "fax_number": "573-783-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S. MINE LAMOTTE",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "63645",
            "telephone_number": "573-783-6256",
            "fax_number": "573-783-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "REAGAN",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "573-783-6256",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericktown, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.