NPIMap

Organization Active NPI

Rocky River Resort, Inc.

  • Home Health Agency
  • Doniphan, MO
National Provider Identifier
1669512083
Registry record updated Aug 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ROCKY RIVER RESORT, INC.
Practice address
109 Smith Dr
Doniphan, MO 63935-1031
Phone
(573) 996-3788
Fax
(573) 996-7870
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2009

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

Authorized official

Name
Dana M Siegler
Title
Billing Adminstrator
Phone
(573) 996-3788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

109 Smith Dr
Doniphan, MO 63935-1031

Mailing address

109 Smith Dr
Doniphan, MO 63935-1031
Phone (573) 996-3788

Other identifiers 5

IdentifierTypeStateIssuer
149332757MedicaidAR
176942765MedicaidAR
283809101MedicaidMO
263809105MedicaidMO
149331752MedicaidAR

Other names 1

  • PREFERRED HOME CARE Doing business as

National Provider Directory

National Provider Directory

Locations

109 Smith Dr
Doniphan, MO 63935
Phone (573) 996-3788

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250726400000",
    "number": "1669512083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 SMITH DR",
            "city": "DONIPHAN",
            "state": "MO",
            "postal_code": "639351031",
            "telephone_number": "573-996-3788",
            "fax_number": "573-996-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 SMITH DR",
            "city": "DONIPHAN",
            "state": "MO",
            "postal_code": "639351031",
            "telephone_number": "573-996-3788",
            "fax_number": "573-996-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY RIVER RESORT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2009-08-20",
        "status": "A",
        "authorized_official_last_name": "SIEGLER",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING ADMINSTRATOR",
        "authorized_official_telephone_number": "573-996-3788"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149332757",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176942765",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283809101",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263809105",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149331752",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PREFERRED HOME CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Doniphan, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.