Pine View Isl

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PINE VIEW ISL

Practice address

4281 Highway 17
Summersville, MO 65571-8204

Phone

(417) 932-4557

Fax

(417) 932-4558

NPI assigned

Mar 21, 2007

Last updated

Aug 22, 2020By 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. Sandra Kay Smith

Title

QMRP

Phone

(417) 932-4557

Specialties & licenses 1

Addresses

Tax ID family

Pine View Christian Home2 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.

• Pine View Christian Home

  • Developmentally Disabled Services Day Training Agency
  • Summersville, MO
  • NPI 1821113408
  NPD tax ID

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770608291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 HORAK DR",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657933576",
            "telephone_number": "417-932-4557",
            "fax_number": "417-932-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4281 HIGHWAY 17",
            "city": "SUMMERSVILLE",
            "state": "MO",
            "postal_code": "655718204",
            "telephone_number": "417-932-4557",
            "fax_number": "417-932-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE VIEW ISL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "QMRP",
        "authorized_official_telephone_number": "417-932-4557",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candi Crabtree
• Candace Lehman
• Mercy Clinic Springfield Communities (Mercy Clinic Family Medicine-Summersville)
• Mercy St Francis Hospital (Mercy Clinic-Summersville)
• Pine View Christian Home
• Regional Services (Coxhealth School Based Telemedicine)
• Tanya Smith
• Makayla Spencer
• Summersville R-II School District
• Cody Whittington, NP

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Summersville, MO
• Providers in Summersville, MO by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.