NPIMap

Organization Active NPI

Bristol Care, Inc.

  • Assisted Living Facility
  • Wentzville, MO
National Provider Identifier
1891901831
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
BRISTOL CARE, INC.
Practice address
840 W Northview Ave
Wentzville, MO 63385-1036
Phone
(636) 639-6777
Fax
(636) 639-6777
NPI assigned
May 15, 2007
Last updated
Oct 3, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Authorized official

Name
Shelley D Ebeling
Title
Medicaid Billing Department
Phone
(660) 826-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

840 W Northview Ave
Wentzville, MO 63385-1036

Mailing address

201 W 3Rd St
Sedalia, MO 65301-4352
Phone (660) 826-0200

Other names 1

  • Bristol Manor of Wentzville Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D1039191Bristol Manor of Wentzville840 West Northview, Wentzville, MO 63385Certificate of waiverApr 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Bristol Care Inc62 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1891901831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W 3RD ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653014352",
            "telephone_number": "660-826-0200",
            "fax_number": "660-827-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 W NORTHVIEW AVE",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633851036",
            "telephone_number": "636-639-6777",
            "fax_number": "636-639-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "EBELING",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAID BILLING DEPARTMENT",
        "authorized_official_telephone_number": "660-826-0200"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bristol Manor of Wentzville",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wentzville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.