Northport Health Services of Missouri, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

NORTHPORT HEALTH SERVICES OF MISSOURI, LLC

Doing business as

Pleasant Hill Health & Rehabilitation Center

Practice address

1300 Broadway St
Pleasant Hill, MO 64080-1842

Phone

(816) 540-2116

NPI assigned

May 26, 2006

Last updated

Oct 9, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Phillip Cody Long

Title

Cfo

Phone

(205) 391-3600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pleasant Hill Health & Rehabilitation Center Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Srinath Tadakamalla, M.D

  • Geriatric Medicine (Family Medicine) Physician
  • Harrisonville, MO
  • NPI 1184691305
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1609822113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 BROADWAY ST",
            "city": "PLEASANT HILL",
            "state": "MO",
            "postal_code": "640801842",
            "telephone_number": "816-540-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BROADWAY ST",
            "city": "PLEASANT HILL",
            "state": "MO",
            "postal_code": "640801842",
            "telephone_number": "816-540-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHPORT HEALTH SERVICES OF MISSOURI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CODY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "205-391-3600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102668209",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pleasant Hill Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pleasant Hill Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kara Beth Meeks, OTR
• Staci L Moore, MS CCC SLP
• Stephanie Ann Moskopp, LPC
• Dawn Christian Myers, LCMFT
• Dung Kim Nguyen, PHARM.D
• Panax Healthcare, Inc (HISCO Infusion)
• Dinesh J Patel, M.D.
• Seth G Pingleton, PT
• Corey S Piva, D.C
• Pleasant Hill Ambulance District

• Skilled Nursing Facility in Pleasant Hill, MO
• Providers in Pleasant Hill, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.