NPIMap

Organization Active NPI

Phoenix Home Care, Inc.

Doing business as Phoenix Home Care

  • Home Health Agency
  • Columbia, MO
National Provider Identifier
1689913394
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PHOENIX HOME CARE, INC.
Doing business as
Phoenix Home Care
Practice address
1410 I 70 Dr SW
Suite 100
Columbia, MO 65203-2068
Phone
(573) 442-9911
Fax
(573) 442-9901
NPI assigned
Feb 1, 2013
Last updated
Feb 1, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
PHOENIX HOME CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Authorized official

Name
Mrs. Sandra Dee Keltner, RN
Title
Administrator
Phone
(417) 881-7442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

1410 I 70 Dr SW
Suite 100
Columbia, MO 65203-2068

Mailing address

1410 I 70 Dr SW
Suite 100
Columbia, MO 65203-2068
Phone (573) 442-9911

Other names 1

  • Phoenix Home Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Home Care LLC14 organizations share this tax ID, including this one
Part of
Phoenix Home Care LLC

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

1410 Interstate 70 Dr SW
Ste 100
Columbia, MO 65203
Phone (573) 442-9911

NPI Registry JSON

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359676800000",
    "number": "1689913394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 I 70 DR SW",
            "address_2": "SUITE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032068",
            "telephone_number": "573-442-9911",
            "fax_number": "573-442-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 I 70 DR SW",
            "address_2": "SUITE 100",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032068",
            "telephone_number": "573-442-9911",
            "fax_number": "573-442-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOME CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOENIX HOME CARE, INC.",
        "enumeration_date": "2013-02-01",
        "last_updated": "2013-02-01",
        "status": "A",
        "authorized_official_last_name": "KELTNER",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "417-881-7442",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

  • 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.