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
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Warren Keith Reagan
Title
Member/Manager
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.

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X
Licensed Practical NurseGroup: 193200000X MULTI-SPECIALTY GROUP 164W00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

120 S. Mine Lamotte
Fredericktown, MO 63645

Mailing address

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 11, 2025.

{
    "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY 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.