Parkside Meadows Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

031754 Issued in MO

Legal business name

PARKSIDE MEADOWS INC.

Practice address

2150 W Randolph St
Saint Charles, MO 63301-0844

Phone

(636) 946-4966

Fax

(636) 946-0214

NPI assigned

Sep 27, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Ray Cearnal

Title

VP of Finance & Technology

Phone

(636) 946-4966

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Carrington Place of St Charles2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Cplace St Charles SNF LLC

  dba Carrington Place of St Charles

  • Skilled Nursing Facility
  • Saint Charles, MO
  • NPI 1679901482
  NPD tax ID

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321833600000",
    "number": "1770579500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 W RANDOLPH ST",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633010844",
            "telephone_number": "636-946-4966",
            "fax_number": "636-946-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 W RANDOLPH ST",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633010844",
            "telephone_number": "636-946-4966",
            "fax_number": "636-946-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE MEADOWS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2011-11-21",
        "status": "A",
        "authorized_official_last_name": "CEARNAL",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "VP OF FINANCE & TECHNOLOGY",
        "authorized_official_telephone_number": "636-946-4966",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "031754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101492908",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chong K Park, M.D.
• Iris Park
• Michelle Lynn Parker, M.A., LPC
• Wyatt Parker
• Kyndra D Parks, RN
• Dennis Alan Parrott, D.M.D.
• Marisa Kristine Passiglia, BCBA
• Dushyant Natvarlal Patel
• Jaimin Patel, PHARM.D.
• Kishan Snehal Patel, PHARM.D.

• Skilled Nursing Facility in Saint Charles, MO
• Providers in Saint Charles, 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 Nov 21, 2011; 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.