Woodbine Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

038446 Issued in MO

Legal business name

WOODBINE HEALTHCARE LLC

Practice address

2900 NE Kendallwood Pkwy
Gladstone, MO 64119-1831

Phone

(816) 453-1222

Fax

(816) 452-5299

NPI assigned

Jun 1, 2006

Organization subpart

No

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

Authorized official

Name

Susan Ludy

Title

Manager

Phone

(816) 453-1222

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Woodbine Healthcare and Rehabilitation Centre Doing business as

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344211200000",
    "number": "1942247481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 NE KENDALLWOOD PKWY",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641191831",
            "telephone_number": "816-453-1222",
            "fax_number": "816-452-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 NE KENDALLWOOD PKWY",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641191831",
            "telephone_number": "816-453-1222",
            "fax_number": "816-452-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBINE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2012-08-06",
        "status": "A",
        "authorized_official_last_name": "LUDY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "816-453-1222"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "038446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942247481",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodbine Healthcare and Rehabilitation Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Ann White, LCSW
• Julie Mary Williams, LMSW
• Rachel Lee Willoughby Greene, MS, LPC, LCPC
• Andrea Gibbs Wilson, LPC
• Alexandra Witt
• Wyllie Chiropractic, PC
• Bennett Micah Wyllie
• James A Wyllie, D.C., D.A.B.C.O.
• James Kent Wyllie, D.C.
• Edmond Michael Young, M.D.

• Skilled Nursing Facility in Gladstone, MO
• Providers in Gladstone, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; 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.