NPIMap

Organization Active NPI

Melissa a Stewart

Doing business as Melissa's Group Home

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Sikeston, MO
National Provider Identifier
1629195607
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
13678892 Issued in MO
Legal business name
MELISSA A STEWART
Doing business as
Melissa's Group Home
Practice address
106 Dacus
Sikeston, MO 63801
Phone
(573) 471-4219
NPI assigned
Mar 23, 2007
Last updated
Sep 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Authorized official

Name
Mrs. Melissa A Stewart, BSNPI 1417214610
Title
Owner
Phone
(573) 471-4219

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 13678892 MO Primary

Addresses

Primary practice location

106 Dacus
Sikeston, MO 63801

Mailing address

106 Dacus Dr
Sikeston, MO 63801-9013
Phone (573) 471-4219

Other identifiers 1

IdentifierTypeStateIssuer
853126100MedicaidMO

Other names 1

  • Melissa's Group Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Melissa a Stewart2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

  • Melissa a Stewart
    • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
    • Sikeston, MO
    • NPI 1013274059
    NPD tax ID

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442534400000",
    "number": "1629195607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 DACUS DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638019013",
            "telephone_number": "573-471-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 DACUS",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "63801",
            "telephone_number": "573-471-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA A STEWART",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2015-09-18",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-471-4219",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "13678892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "853126100",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melissa's Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sikeston, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.