Active NPI
Paul Nelson Eddy
- Contractor
- Harrisonville, MO
National Provider Identifier
1669713947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- LC1066421
- Practice address
- 25410 E State Route Ee
Harrisonville, MO 64701-4403 - Phone
- (816) 260-2924
- Fax
- (816) 884-4703
- NPI assigned
- Mar 11, 2013
- Last updated
- Mar 11, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | LC1066421 | MO | Primary |
Addresses
Primary practice location
25410 E State Route Ee
Harrisonville, MO 64701-4403
Mailing address
25410 E State Route Ee
Harrisonville, MO 64701-4403
Phone (816) 260-2924
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC1066421 | MO | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362960000000",
"number": "1669713947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25410 E STATE ROUTE EE",
"city": "HARRISONVILLE",
"state": "MO",
"postal_code": "647014403",
"telephone_number": "816-260-2924",
"fax_number": "816-884-4703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25410 E STATE ROUTE EE",
"city": "HARRISONVILLE",
"state": "MO",
"postal_code": "647014403",
"telephone_number": "816-260-2924",
"fax_number": "816-884-4703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDDY",
"first_name": "PAUL",
"middle_name": "NELSON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-11",
"last_updated": "2013-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "MO",
"license": "LC1066421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrisonville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.