NPIMap

Organization Active NPI

Heartland Residential Care Facility, Inc.

  • Assisted Living Facility
  • Saint Joseph, MO
National Provider Identifier
1558071134
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
HEARTLAND RESIDENTIAL CARE FACILITY, INC.
Practice address
1606 S 38TH St
Saint Joseph, MO 64507-2216
Phone
(816) 390-8941
Fax
(816) 279-7728
NPI assigned
Dec 5, 2022
Organization subpart
Yes
Parent organization
HEARTLAND III RESIDENTIAL CARE FACILITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Authorized official

Name
Brooke A Waitkoss
Title
Owner
Phone
(816) 676-1506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1606 S 38TH St
Saint Joseph, MO 64507-2216

Mailing address

1606 S 38TH St
Saint Joseph, MO 64507-2216
Phone (816) 390-8941

Other identifiers 3

IdentifierTypeStateIssuer
00587818MedicaidMO
22268115MedicaidMO
65069904MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awaitkoss@heartlandrcf.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Heartland Residential Care Facility Inc3 organizations share this tax ID, including this one
Part of
Heartland Residential Care Facility Inc

Other organizations with this tax ID 2

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

Locations

1606 S 38th St
Saint Joseph, MO 64507
Phone (816) 390-8941

NPI Registry JSON

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1558071134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 S 38TH ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645072216",
            "telephone_number": "816-390-8941",
            "fax_number": "816-279-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 S 38TH ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645072216",
            "telephone_number": "816-390-8941",
            "fax_number": "816-279-7728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND RESIDENTIAL CARE FACILITY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND III RESIDENTIAL CARE FACILITY",
        "enumeration_date": "2022-12-05",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "WAITKOSS",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-676-1506"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00587818",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22268115",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65069904",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awaitkoss@heartlandrcf.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1606 S 38th St",
            "city": "Saint Joseph",
            "state": "MO",
            "country_code": "US",
            "postal_code": "645072216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.