NPIMap

Organization Active NPI

Phoenix Home Care Inc

  • Home Health Agency
  • Springfield, MO
National Provider Identifier
1750894366
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
267629 Issued in MO
Legal business name
PHOENIX HOME CARE INC
Practice address
1839 E Independence St Ste K
Springfield, MO 65804-3753
Phone
(417) 881-7442
Fax
(417) 889-7442
NPI assigned
Nov 6, 2017
Organization subpart
Yes
Parent organization
PHOENIX HOME CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Authorized official

Name
Gregory Alex Melugin
Title
VP of Operations
Phone
(316) 688-5511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 267629 MO Primary

Addresses

Primary practice location

1839 E Independence St Ste K
Springfield, MO 65804-3753

Mailing address

3033 S Kansas Expy
Springfield, MO 65807-5969
Phone (417) 881-7442

Other identifiers 1

IdentifierTypeStateIssuer
266501303MedicaidMO

Other names 3

  • Phoenix Home Care and Hoispice Doing business as
  • Phoenix Home Care and Hospice Doing business as
  • Phoenix Palliative Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Home Care LLC14 organizations share this tax ID, including this one
Part of
Phoenix Home Care LLC

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1750894366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 S KANSAS EXPY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075969",
            "telephone_number": "417-881-7442",
            "fax_number": "417-889-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 E INDEPENDENCE ST STE K",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658043753",
            "telephone_number": "417-881-7442",
            "fax_number": "417-889-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOME CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOENIX HOME CARE INC",
        "enumeration_date": "2017-11-06",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "MELUGIN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "ALEX",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "316-688-5511"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "267629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266501303",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Home Care and Hoispice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phoenix Home Care and Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phoenix Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.