Kidwell Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

032825 Issued in MO

Legal business name

KIDWELL HOME

Practice address

1000 Kidwell Drive
Versailles, MO 65084

Phone

(573) 378-5411

Fax

(573) 378-5415

NPI assigned

Dec 14, 2007

Organization subpart

Yes

Parent organization

GOOD SHEPHERD NURSING HOME DISTRICTAs reported in NPPES

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

Authorized official

Name

Mrs. Sandi Leonard

Title

Administrator

Phone

(573) 378-5411

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1649453408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 W CLAY RD",
            "city": "VERSAILLES",
            "state": "MO",
            "postal_code": "650849314",
            "telephone_number": "573-378-5411",
            "fax_number": "573-378-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 KIDWELL DRIVE",
            "city": "VERSAILLES",
            "state": "MO",
            "postal_code": "65084",
            "telephone_number": "573-378-5411",
            "fax_number": "573-378-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDWELL HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOOD SHEPHERD NURSING HOME DISTRICT",
        "enumeration_date": "2007-12-14",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "SANDI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-378-5411",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "032825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrity Lifeskills LLC
• JRS Enterprises II Missouri LLC (Versailles Pharmacy LTC)
• JRS Enterprises II Missouri LLC (Versailles Pharmacy)
• Ashley Joann Judd, LPN
• Kevin K.E. Carl, O.D. Dba Eye Clinic
• Rebecca Elaine Kimbell, MSN, APRN, CNP
• Julie Kisner, LCSW
• Mary Kloeppel
• Sunshine Lafoy
• Laurie Pharmacy Inc (Senior Pharmacy)

• Assisted Living Facility in Versailles, MO
• Providers in Versailles, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.