Magnolia Manor, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

032816 Issued in MO

Legal business name

MAGNOLIA MANOR, INC.

Practice address

RR 2 Box 265C
Purdy, MO 65734-9507

Phone

(417) 442-3633

Fax

(417) 442-3635

NPI assigned

May 22, 2007

Last updated

Aug 22, 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

Ms. Sheri L Davidson

Title

President

Phone

(417) 442-3633

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649489949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 265C",
            "city": "PURDY",
            "state": "MO",
            "postal_code": "657349507",
            "telephone_number": "417-442-3633",
            "fax_number": "417-442-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 265C",
            "city": "PURDY",
            "state": "MO",
            "postal_code": "657349507",
            "telephone_number": "417-442-3633",
            "fax_number": "417-442-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "SHERI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-442-3633",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "032816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Bennett, FNP
• Beverly Bond
• Johnny L Bowman, OD
• Linda Marie Kee, M.S.W, L.C.S.W
• Diane Mobley, LPC
• Purdy Eyes Optometry, LLC
• Purdy R-II Schools

• Assisted Living Facility in Purdy, MO
• Providers in Purdy, 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 Aug 22, 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.