Quail Creek Skilled Nursing, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

032174 Issued in MO

Legal business name

QUAIL CREEK SKILLED NURSING, LLC

Practice address

1514 West Lark
Springfield, MO 65810

Phone

(417) 889-1275

Fax

(417) 881-0657

NPI assigned

Mar 30, 2006

Organization subpart

No

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

Authorized official

Name

James Reiker

Title

Treasurer

Phone

(417) 889-1275

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Neighborhoods at Quail Creek Doing business as

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359676800000",
    "number": "1669433629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 WEST LARK",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65810",
            "telephone_number": "417-889-1275",
            "fax_number": "417-881-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 WEST LARK",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65810",
            "telephone_number": "417-889-1275",
            "fax_number": "417-881-0657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAIL CREEK SKILLED NURSING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-30",
        "last_updated": "2013-02-01",
        "status": "A",
        "authorized_official_last_name": "REIKER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "417-889-1275"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "032174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102679008",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Neighborhoods at Quail Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wayne E Putnam, D.O.
• Paul Dennis Putt, A.T., C.
• Bailey M Pyle, MA, LPC
• Susan E. Pyle, PSYD, LP
• Jason Pyrah, M.S., ATC
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• Kevin Qualls, PLPC
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• Skilled Nursing Facility in Springfield, MO
• Providers in Springfield, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.