NPIMap

Organization Active NPI

Covenant Care Services, LLC

  • Licensed Practical Nurse
  • Fredericktown, MO
National Provider Identifier
1770623266
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
Legal business name
COVENANT CARE SERVICES, LLC
Practice address
120 S Mine la Motte St
Fredericktown, MO 63645-1229
Phone
(573) 783-6256
Fax
(573) 783-8148
NPI assigned
Feb 7, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Warren K Reagan
Title
Member-Manager
Phone
(573) 783-6256

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X
Personal Care Attendant 3747P1801X
Home Health Aide 374U00000X
Nurse's Aide 376K00000X
Registered Nurse 163W00000X
Licensed Practical Nurse 164W00000X Primary

Addresses

Primary practice location

120 S Mine la Motte St
Fredericktown, MO 63645-1229

Mailing address

120 S Mine la Motte St
Fredericktown, MO 63645-1229
Phone (573) 783-6256

National Provider Directory

National Provider Directory
Tax ID family
Covenant Care Services LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1770623266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S MINE LA MOTTE ST",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "636451229",
            "telephone_number": "573-783-6256",
            "fax_number": "573-783-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S MINE LA MOTTE ST",
            "city": "FREDERICKTOWN",
            "state": "MO",
            "postal_code": "636451229",
            "telephone_number": "573-783-6256",
            "fax_number": "573-783-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "REAGAN",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEMBER-MANAGER",
        "authorized_official_telephone_number": "573-783-6256",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericktown, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.