Proactive Home Care Missouri, Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PROACTIVE HOME CARE MISSOURI, INC.

Practice address

336 Grant St
Carthage, MO 64836-1632

Phone

(206) 549-7756

Fax

(877) 671-3066

NPI assigned

Jun 13, 2015

Organization subpart

No

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

Authorized official

Name

Eric William Kelly

Title

Owner and Ceo

Phone

(206) 549-7756

Specialties & licenses 1

Addresses

Other names 1

• Planned Wellness Doing business as

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

{
    "created_epoch": "1434153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493942400000",
    "number": "1821479064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 GRANT ST",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648361632",
            "telephone_number": "206-549-7756",
            "fax_number": "417-472-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 GRANT ST",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648361632",
            "telephone_number": "206-549-7756",
            "fax_number": "877-671-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE HOME CARE MISSOURI, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-13",
        "last_updated": "2017-05-05",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER AND CEO",
        "authorized_official_telephone_number": "206-549-7756"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Planned Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aaron M. Petersen, CRNA
• Robyn Ladawn Petersen, LCSW
• Joshua David Pingel, PHARMD
• Jeanine Ann Poe, LMT
• Proactive Home Care Missouri, Inc.
• Amy O Puderbaugh, DO
• Michelle Lea Pyle, O.D.
• Luke Douglas Pyron, MD
• Joseph Thomas Quay III, D.O.
• Shawna Rambo

• In Home Supportive Care Agency in Carthage, MO
• Providers in Carthage, MO by specialty
• In Home Supportive Care Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; 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.