Residential Hospice of Southern Illinois, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

RESIDENTIAL HOSPICE OF SOUTHERN ILLINOIS, LLC

Doing business as

Residential Hospice of E MO

Practice address

8706 Manchester Rd Ste 102
Saint Louis, MO 63144-2733

Phone

(314) 266-0950

NPI assigned

Aug 18, 2022

Last updated

Aug 18, 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

Justin Dewitte

Title

President / Ceo

Phone

(866) 902-4000

Specialties & licenses 1

Addresses

Other names 1

• Residential Hospice of E MO Doing business as

Locations

Practitioners 4

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.

• Melissa Baker, AGPCNP-BC

  • Primary Care Nurse Practitioner
  • Troy, MI
  • NPI 1003369307
  NPD
• Lindsay Michelle Franks, FNP

  • Family Nurse Practitioner
  • Lake Havasu City, AZ
  • NPI 1831815893
  NPD
• Kirby L Klostermann, FNP

  • Nurse Practitioner
  • Glen Carbon, IL
  • NPI 1285829572
  NPD
• Farah Siddique, NP-C

  • Family Nurse Practitioner
  • Schaumburg, IL
  • NPI 1417639501
  NPD

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1750009452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 CORPORATE DR STE 400",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480982645",
            "telephone_number": "866-902-4000",
            "fax_number": "866-903-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8706 MANCHESTER RD STE 102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631442733",
            "telephone_number": "314-266-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL HOSPICE OF SOUTHERN ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "DEWITTE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "866-902-4000"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Residential Hospice of E MO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jamie Reski, PHARM.D.
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• Community Based Hospice Care Agency in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Community Based Hospice Care Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.