NPIMap

Organization Active NPI

Bootheel Area Independent Living Services, Inc.

  • Home Health Agency
  • Kennett, MO
National Provider Identifier
1861557183
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
01 Issued in MO
Legal business name
BOOTHEEL AREA INDEPENDENT LIVING SERVICES, INC.
Practice address
719 Teaco Rd
Kennett, MO 63857-3741
Phone
(573) 888-0002
Fax
(573) 888-0708
NPI assigned
Dec 27, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Tim B Shaw
Title
Executive Director
Phone
(573) 888-0002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 01 MO Primary

Addresses

Primary practice location

719 Teaco Rd
Kennett, MO 63857-3741

Mailing address

PO Box 326
719 Teaco Road
Kennett, MO 63857-0326
Phone (573) 888-0002

National Provider Directory

National Provider Directory
Tax ID family
Bails2 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.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861557183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 326",
            "address_2": "719 TEACO ROAD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638570326",
            "telephone_number": "573-888-0002",
            "fax_number": "573-888-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 TEACO RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573741",
            "telephone_number": "573-888-0002",
            "fax_number": "573-888-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOTHEEL AREA INDEPENDENT LIVING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "573-888-0002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 21, 2022; 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.