Active NPI
Adrain Gillispie
- Home Health Agency
- Saint Ann, MO
National Provider Identifier
1679899702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 11140 Old Saint Charles Rd
Saint Ann, MO 63074-2113 - Phone
- (314) 429-6949
- NPI assigned
- Apr 14, 2010
- Last updated
- Apr 14, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | NU | Primary |
Addresses
Primary practice location
11140 Old Saint Charles Rd
Saint Ann, MO 63074-2113
Mailing address
11140 Old St. Charles Rock Rd.
St. Louis, MO 63074
Phone (314) 429-6949
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 431811807 | Medicaid | MO |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Royal Direct Care Services | Home Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Home Health Agency
- Saint Ann, MO
- NPI 1891935219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271203200000",
"number": "1679899702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11140 OLD ST. CHARLES ROCK RD.",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "63074",
"telephone_number": "314-429-6949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11140 OLD SAINT CHARLES RD",
"city": "SAINT ANN",
"state": "MO",
"postal_code": "630742113",
"telephone_number": "314-429-6949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLISPIE",
"first_name": "ADRAIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-14",
"last_updated": "2010-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "431811807",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Ann, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.