NPIMap

Organization Active NPI

Clark County Nursing Service & Home Health Agency

  • Home Health Aide
  • Kahoka, MO
National Provider Identifier
1851428593
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Legal business name
CLARK COUNTY NURSING SERVICE & HOME HEALTH AGENCY
Practice address
670 N Johnson St
Kahoka, MO 63445-1430
Phone
(660) 727-2356
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Authorized official

Name
Mrs. M Evelena Sutterfield, RN
Title
Administrator
Phone
(660) 727-2356

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X MO Primary

Addresses

Primary practice location

670 N Johnson St
Kahoka, MO 63445-1430

Mailing address

670 N Johnson St
P O Box 12
Kahoka, MO 63445-1430
Phone (660) 727-2356

Other identifiers 1

IdentifierTypeStateIssuer
260562707MedicaidMO

Other names 1

  • Clark County Health Department Home Health Agency Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clark County Health Department Home Health Agency3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364256000000",
    "number": "1851428593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 N JOHNSON ST",
            "address_2": "P O BOX 12",
            "city": "KAHOKA",
            "state": "MO",
            "postal_code": "634451430",
            "telephone_number": "660-727-2356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 N JOHNSON ST",
            "city": "KAHOKA",
            "state": "MO",
            "postal_code": "634451430",
            "telephone_number": "660-727-2356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK COUNTY NURSING SERVICE & HOME HEALTH AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2013-03-26",
        "status": "A",
        "authorized_official_last_name": "SUTTERFIELD",
        "authorized_official_first_name": "M",
        "authorized_official_middle_name": "EVELENA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "660-727-2356",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260562707",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark County Health Department Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kahoka, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.