Barefootboy LLC

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

035394 Issued in MO

Legal business name

BAREFOOTBOY LLC

Doing business as

Oakbrook Residence

Practice address

723 S Scenic Ave
723 S.Scenic
Springfield, MO 65802-5042

Phone

(417) 864-6200

Fax

(417) 864-4413

NPI assigned

Jul 28, 2008

Last updated

Jul 28, 2008By 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

Mr. Rajab Tongwa Echessa, ADMINISTRATORNPI 1902204365

Title

Administrator

Phone

(417) 207-1680

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• OAKBROOK RESIDENCE Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rajab Echessa

  • Occupational Therapist
  • Springfield, MO
  • NPI 1902204365
  Authorized official Same address or phone

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1790940989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 S SCENIC AVE",
            "address_2": "723 S.SCENIC",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658025042",
            "telephone_number": "417-864-6200",
            "fax_number": "417-864-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 S SCENIC AVE",
            "address_2": "723 S.SCENIC",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658025042",
            "telephone_number": "417-864-6200",
            "fax_number": "417-864-4413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAREFOOTBOY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-28",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "ECHESSA",
        "authorized_official_first_name": "RAJAB",
        "authorized_official_middle_name": "TONGWA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "417-207-1680",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "MO",
            "license": "035394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266758408",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OAKBROOK RESIDENCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Banyan Group, Inc. (Headache Care Center)
• Kathryn Barber, NP
• Sarah R. Barber, AUD
• Joshua Matthew Barbieri, P.A.
• Linda Sue Barboa
• Trevor Barger, LPC
• Dawn Barker, D.O.
• Michael J Barker, M.D.
• Tiffany Lin Barker, FNP-C
• William Francis Barker, DO

• Physical Disabilities Residential Treatment Facility in Springfield, MO
• Providers in Springfield, MO by specialty
• Physical Disabilities Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.