NPIMap

Organization Active NPI

Sunnyside Home Healthcare LLC

  • Home Health Agency
  • Bridgeton, MO
National Provider Identifier
1699348466
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SUNNYSIDE HOME HEALTHCARE LLC
Practice address
3431 Bridgeland Dr Ste H
Bridgeton, MO 63044-2648
Phone
(314) 262-2081
NPI assigned
Jul 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Authorized official

Name
Keisha L WatersNPI 1023850716
Title
Executive Director
Phone
(314) 262-2081

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3431 Bridgeland Dr Ste H
Bridgeton, MO 63044-2648

Mailing address

2065 Walton Rd Ste 111
Saint Louis, MO 63114-5805
Phone (314) 262-2081

National Provider Directory

National Provider Directory
Tax ID family
Sunnyside Home Healthcare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2065 Walton Rd
Ste 111
Saint Louis, MO 63114

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1699348466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 WALTON RD STE 111",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631145805",
            "telephone_number": "314-262-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3431 BRIDGELAND DR STE H",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442648",
            "telephone_number": "314-262-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYSIDE HOME HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "314-262-2081"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.