Lessie Bates Davis Neighborhood House

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LESSIE BATES DAVIS NEIGHBORHOOD HOUSE

Practice address

1200 North 13TH Street
East Saint Louis, IL 62205

Phone

(618) 874-0777

Fax

(618) 874-0511

NPI assigned

Oct 19, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Christopher K Coleman, BSHR, MBA

Title

Sr. Vice President

Phone

(618) 874-0777

Specialties & licenses 5

Addresses

Tax ID family

Lessie Bates Davis Neighborhood House2 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.

• Lessie Bates Davis Neighborhood House

  • In Home Supportive Care Agency
  • East Saint Louis, IL
  • NPI 1659796456
  NPD tax ID

Locations

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1790156610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NORTH 13TH",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "62205",
            "telephone_number": "618-874-0777",
            "fax_number": "618-874-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NORTH 13TH STREET",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "62205",
            "telephone_number": "618-874-0777",
            "fax_number": "618-874-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESSIE BATES DAVIS NEIGHBORHOOD HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT",
        "authorized_official_telephone_number": "618-874-0777",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSHR, MBA"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryana F Kirolos, D.D.S.
• Denise J Krone, FNP,BC
• Jean Lammers, PT
• Felicia Gabriel Larkin
• Lessie Bates Davis Neighborhood House
• Carla Renee Lewis, D.D.S.
• Danielle M Loftus, DNP, APRN, FNP-BC
• Albert Long
• Christopher Jacob Loynd, D.O.
• Lutheran Social Services of Illinois

• Physical Therapist in East Saint Louis, IL
• Providers in East Saint Louis, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.