Fidelis Support Services LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

FIDELIS SUPPORT SERVICES LLC

Practice address

3905 Faurot Dr
Columbia, MO 65203-0309

Phone

(573) 424-4367

NPI assigned

Sep 10, 2010

Last updated

Sep 10, 2010By 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

Mr. Douglas L Edgar

Title

Owner/QDDP

Phone

(573) 424-4367

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284076800000",
    "number": "1699082743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 FAUROT DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652030309",
            "telephone_number": "573-424-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 FAUROT DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652030309",
            "telephone_number": "573-424-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIDELIS SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-10",
        "last_updated": "2010-09-10",
        "status": "A",
        "authorized_official_last_name": "EDGAR",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/QDDP",
        "authorized_official_telephone_number": "573-424-4367",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Ellen Feutz, ACNS-BC
• FG Medical Supplies
• Kyle Fiala, DPM
• Gracie E Fiaoni, PTA
• Whitney Diane Ficker, MD
• Fidelity Non Emergency Medical Transportation
• Brenton Field
• Danielle M Field, PHARM.D. BCPS
• Linda S Fields, PA
• Logan Fifer

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Columbia, MO
• Providers in Columbia, MO by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.

Verify at the official NPI Registry.