Cerebral Palsy of Tri-County, Inc.

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

001189440 Issued in MO

Legal business name

CEREBRAL PALSY OF TRI-COUNTY, INC.

Practice address

1401 W Austin St
Webb City, MO 64870-1617

Phone

(417) 673-4940

Fax

(417) 673-8550

NPI assigned

Apr 2, 2013

Last updated

Apr 2, 2013By 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

Dr. Christy Groves Graham, ED.D.

Title

Executive Director

Phone

(417) 673-4940

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364860800000",
    "number": "1639412281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 W AUSTIN ST",
            "city": "WEBB CITY",
            "state": "MO",
            "postal_code": "648701617",
            "telephone_number": "417-673-4940",
            "fax_number": "417-673-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W AUSTIN ST",
            "city": "WEBB CITY",
            "state": "MO",
            "postal_code": "648701617",
            "telephone_number": "417-673-4940",
            "fax_number": "417-673-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEREBRAL PALSY OF TRI-COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-02",
        "last_updated": "2013-04-02",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_middle_name": "GROVES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "417-673-4940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "MO",
            "license": "001189440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.