NPIMap

Organization Active NPI

Visiting Nurse Association of Southeast Missouri Inc

  • Home Health Agency
  • Kennett, MO
National Provider Identifier
1710959309
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
158-21 Issued in MO
Legal business name
VISITING NURSE ASSOCIATION OF SOUTHEAST MISSOURI INC
Practice address
1124 Independence Ave
Kennett, MO 63857-1314
Phone
(573) 888-5892
Fax
(573) 888-0538
NPI assigned
Feb 7, 2006
Last updated
Jan 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Authorized official

Name
Mrs. Shonda Hollomon Young
Title
Ceo
Phone
(573) 888-5892

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 158-21 MO Primary

Addresses

Primary practice location

1124 Independence Ave
Kennett, MO 63857-1314

Mailing address

PO Box 768
Kennett, MO 63857-0768
Phone (573) 888-5892

Other identifiers 1

IdentifierTypeStateIssuer
940620206MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Visiting Nurse Association of Southeast Missouri Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578960000000",
    "number": "1710959309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 768",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638570768",
            "telephone_number": "573-888-5892",
            "fax_number": "573-888-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 INDEPENDENCE AVE",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638571314",
            "telephone_number": "573-888-5892",
            "fax_number": "573-888-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISITING NURSE ASSOCIATION OF SOUTHEAST MISSOURI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "SHONDA",
        "authorized_official_middle_name": "HOLLOMON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-888-5892",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "158-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "940620206",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.