Xtracomfort Home Health Agency, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

XTRACOMFORT HOME HEALTH AGENCY, LLC

Practice address

6311 Evanston Ave Ste a
Raytown, MO 64133-4929

Phone

(816) 328-9304

NPI assigned

May 31, 2019

Organization subpart

No

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

Authorized official

Name

Aderemi Miller, MBA, BSN, RN

Title

Administrator

Phone

(816) 328-9304

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559260800000",
    "number": "1881252385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6311 EVANSTON AVE STE A",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641334929",
            "telephone_number": "816-328-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6311 EVANSTON AVE STE A",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641334929",
            "telephone_number": "816-328-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XTRACOMFORT HOME HEALTH AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ADEREMI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "816-328-9304",
        "authorized_official_credential": "MBA, BSN, RN"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700253150",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952727273",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; 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.