Macon County Sheltered Workshop

Primary specialty

Private VehicleTaxonomy code 347C00000X

Legal business name

MACON COUNTY SHELTERED WORKSHOP

Doing business as

Macon Diversified Industries

Practice address

1103 Enterprise Rd
Macon, MO 63552-1305

Phone

(660) 385-3111

Fax

(660) 395-9578

NPI assigned

Mar 23, 2020

Last updated

Mar 23, 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

Ellen D Spidle

Title

Office Manager

Phone

(660) 385-3111

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Macon Diversified Industries Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584921600000",
    "number": "1679100507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 ENTERPRISE RD",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635521305",
            "telephone_number": "660-385-3111",
            "fax_number": "660-395-9578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 ENTERPRISE RD",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635521305",
            "telephone_number": "660-385-3111",
            "fax_number": "660-395-9578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACON COUNTY SHELTERED WORKSHOP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A",
        "authorized_official_last_name": "SPIDLE",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "660-385-3111"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M857758502",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdibusiness@hotmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1103 Enterprise Rd",
            "city": "Macon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "635521305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Macon Diversified Industries",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Macon County Samaritan Hospital (Samaritan Hospital)
• Macon County Samaritan Hospital
• Macon County Samaritan Hospital (Samaritan Hospital)
• Macon County Samaritan Hospital (Total Family Healthcare)
• Macon County Samaritan Hospital
• Macon Rehabilitation Services, LLC
• Mark Vincent Maddox, O.D.
• Donet Christopher Main, DO
• Jessica March, MSN, FNP-BC
• William Walter Marshall II, D.D.S.

• Private Vehicle in Macon, MO
• Providers in Macon, MO by specialty
• Private Vehicle in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.