NPIMap

Organization Active NPI

Kennett Hma LLC

  • Rural Health Clinic/Center
  • Kennett, MO
National Provider Identifier
1851618011
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
KENNETT HMA LLC
Doing business as
Twin Rivers Pediatrics
Practice address
1312 1St St
Kennett, MO 63857-2526
Phone
(573) 717-1080
Fax
(573) 717-1093
NPI assigned
Apr 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Authorized official

Name
Laurie Holtsford
Title
Authorized Official
Phone
(615) 465-7466

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 2009008960 MO
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1312 1St St
Kennett, MO 63857-2526

Mailing address

1312 1St St
Kennett, MO 63857-2526
Phone (573) 717-1080

Other names 1

  • Twin Rivers Pediatrics Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1851618011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 1ST ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572526",
            "telephone_number": "573-717-1080",
            "fax_number": "573-717-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 1ST ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572526",
            "telephone_number": "573-717-1080",
            "fax_number": "573-717-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETT HMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-28",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "HOLTSFORD",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-465-7466"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2009008960",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twin Rivers Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennett, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.