Kingdom Care Alf LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

KINGDOM CARE ALF LLC

Practice address

811 Center St
Fulton, MO 65251-1922

Phone

(573) 642-6646

Fax

(573) 642-2202

NPI assigned

Apr 2, 2026

Organization subpart

No

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

Authorized official

Name

Nathan Goldberg

Title

Medicare Authorized Official

Phone

(443) 208-1826

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1775088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1497696785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 UNION AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 CENTER ST",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652511922",
            "telephone_number": "573-642-6646",
            "fax_number": "573-642-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM CARE ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "MEDICARE AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "443-208-1826"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Jo Johnmeyer, MSW, LCSW
• Robert William Johnson, PH.D.
• Joshua S. Prather DDS, LLC
• Jwtdo, LLC
• John L Keener, RPH
• Kingdom Care Assisted Living, LLC
• Kingdom Care Opco LLC
• Kingdom Care Senior Living, LLC
• Jeffrey S. Kline, PH.D.
• Morgan Kluge, MD

• Assisted Living Facility in Fulton, MO
• Providers in Fulton, 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 Apr 2, 2026; 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.