Charis Healthcare of Missouri LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

CHARIS HEALTHCARE OF MISSOURI LLC

Practice address

1815 Katelyn St
Kennett, MO 63857-4112

Phone

(870) 489-8633

NPI assigned

Oct 20, 2025

Organization subpart

No

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

Authorized official

Name

Tiffany Lynn Moore, ARPN

Title

Owner

Phone

(870) 489-8633

Specialties & licenses 1

Addresses

Tax ID family

Charis Healthcare of Missouri LLC2 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.

• Charis Healthcare of Missouri LLC

  • Nurse Practitioner
  • Kennett, MO
  • NPI 1265394431
  NPD tax ID

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760918400000",
    "number": "1669349213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 KATELYN ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638574112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 KATELYN ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638574112",
            "telephone_number": "870-489-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARIS HEALTHCARE OF MISSOURI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-489-8633",
        "authorized_official_credential": "ARPN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Center for Women'S Health LLC
• Keith Lynn Chadwell
• Ruth Chailland
• Katrina Lynn Chambers
• Charis Healthcare of Missouri LLC
• Lisa Chastain, LPN
• Danielle Marie Chidister
• Michelle Lynn Chrisman-Sadler
• Kica Christian
• Joshua Chronister

• Family Nurse Practitioner in Kennett, MO
• Providers in Kennett, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.