South Central Missouri Angels, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

SOUTH CENTRAL MISSOURI ANGELS, LLC

Practice address

602 W 6TH St Ste B
Rolla, MO 65401-2983

Phone

(573) 458-6993

Fax

(573) 415-8990

NPI assigned

Mar 20, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Karl JacobsNPI 1205385564

Title

Owner

Phone

(573) 458-6993

Specialties & licenses 1

Addresses

Other names 1

• Visiting Angels of Rolla Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karl Jacobs

  • In Home Supportive Care Agency
  • Rolla, MO
  • NPI 1205385564
  NPD (past) Authorized official

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553040000000",
    "number": "1497215131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 W 6TH ST STE B",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012983",
            "telephone_number": "573-458-6993",
            "fax_number": "573-415-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W 6TH ST STE B",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012983",
            "telephone_number": "573-458-6993",
            "fax_number": "573-415-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL MISSOURI ANGELS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-20",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "KARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-458-6993",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Visiting Angels of Rolla",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phillip Dean Smith, LPC, NCC
• Amy Snodgrass, LMSW
• Chun Ho So, MD
• John-Paul Soberano, MD
• Lauren Sommero, CPNP
• South Central Missouri Community Health Center
• South Central Missouri Community Health Center
• South Central Missouri Community Health Center
• South Central Missouri Community Health Center
• South Central Missouri Community Health Center

• In Home Supportive Care Agency in Rolla, MO
• Providers in Rolla, MO by specialty
• In Home Supportive Care Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; 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.