Magnificent Caring Home Health

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MAGNIFICENT CARING HOME HEALTH

Practice address

12215 Winterset Dr
Black Jack, MO 63033-7333

Phone

(314) 629-7281

Fax

(314) 699-4648

NPI assigned

Sep 3, 2020

Last updated

Sep 2, 2022By 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

Mrs. Tamicka Nelson-BoboNPI 1316558281

Title

Owner/ Director

Phone

(314) 629-7281

Specialties & licenses 9

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tamicka Nelson- Bobo

  • Home Health Agency
  • Black Jack, MO
  • NPI 1316558281

  Behavior Analyst

  NPD Authorized official

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1740894013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12215 WINTERSET DR",
            "city": "BLACK JACK",
            "state": "MO",
            "postal_code": "630337333",
            "telephone_number": "314-629-7281",
            "fax_number": "314-699-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12215 WINTERSET DR",
            "city": "BLACK JACK",
            "state": "MO",
            "postal_code": "630337333",
            "telephone_number": "314-629-7281",
            "fax_number": "314-699-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNIFICENT CARING HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "NELSON-BOBO",
        "authorized_official_first_name": "TAMICKA",
        "authorized_official_title_or_position": "OWNER/ DIRECTOR",
        "authorized_official_telephone_number": "314-629-7281",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "132700000X",
            "taxonomy_group": "",
            "desc": "Dietary Manager",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740894013",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "magnificentcaringhh2019@gmail.com",
            "affiliation": "N",
            "address_1": "12215 Winterset Dr",
            "city": "Black Jack",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630337333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Home Health Agency in Black Jack, MO
• Providers in Black Jack, MO by specialty
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.