Independence Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

035303 Issued in MO

Legal business name

INDEPENDENCE OPERATIONS LLC

Doing business as

The Villages of Jackson Creek

Practice address

3980 S. Jackson Dr.
Independence, MO 64057-1706

Phone

(816) 795-1433

Fax

(816) 795-1766

NPI assigned

Sep 25, 2007

Last updated

Jun 2, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

STONEGATE SENIOR CARE, LPAs reported in NPPES

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

Authorized official

Name

Paula Pierce

Title

Authorized Officer

Phone

(972) 899-4401

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• The Villages of Jackson Creek Doing business as

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1760679625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WATERS RIDGE DR",
            "address_2": "STE 200",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576011",
            "telephone_number": "972-899-4401",
            "fax_number": "972-899-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 S. JACKSON DR.",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571706",
            "telephone_number": "816-795-1433",
            "fax_number": "816-795-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE OPERATIONS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STONEGATE SENIOR CARE, LP",
        "enumeration_date": "2007-09-25",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICER",
        "authorized_official_telephone_number": "972-899-4401"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "035304",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "035303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101488302",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Villages of Jackson Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Independence Manor Inc (Independence Manor Care Center)
• Independence MC, LLC (Jackson Creek Memory Care)
• Independence Medical Group PC
• Independence Mo Consulting LLC (Polaris Health & Wellness of Independence)
• Independence Neurosurgery Services LLC (Midwest Brain and Spine Associates)
• Independence Orthodontics, LLC
• Independence Pediatric Dentistry LLC
• Independence Pediatrics PC
• Independence Pediatrics, P.C. Inc.
• Independence Regional Medical Group LLC (Heritage Physicians Group)

• Skilled Nursing Facility in Independence, MO
• Providers in Independence, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.