Tiffany Care Centers, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

037434 Issued in MO

Legal business name

TIFFANY CARE CENTERS, INC.

Doing business as

Nodaway Nursing Home

Practice address

22371 State Highway 46
Maryville, MO 64468-8157

Phone

(660) 562-2876

Fax

(660) 562-7558

NPI assigned

May 4, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Kelly Summa

Title

Administrator

Phone

(660) 562-2876

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Nodaway Nursing Home Doing business as

Locations

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1619295409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "address_2": "22371 STATE HIGHWAY 46",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644688157",
            "telephone_number": "660-562-2876",
            "fax_number": "660-562-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22371 STATE HIGHWAY 46",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644688157",
            "telephone_number": "660-562-2876",
            "fax_number": "660-562-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFFANY CARE CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-04",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "SUMMA",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "660-562-2876",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "037434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26A500",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102385408",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nodaway Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Ellen Theodore, LPC
• Kenneth T. Thom, LPC
• Kyle B Thomas
• Athena R Thompson
• Vicki Lee Thompson, LCSW
• Regan Tripp, R.D.
• Amanda Twaddle
• Bruce E Twaddle, DDS
• Spencer B Twaddle, DDS
• Village Care Center, Inc

• Skilled Nursing Facility in Maryville, MO
• Providers in Maryville, 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 May 26, 2015; 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.