NPIMap

Organization Active NPI

Phoenix Home Care, LLC

  • In Home Supportive Care Agency
  • Springfield, MO
National Provider Identifier
1962793547
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
PHOENIX HOME CARE, LLC
Practice address
1839 E Independence St Ste K
Springfield, MO 65804-3753
Phone
(417) 818-3565
NPI assigned
Apr 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Authorized official

Name
George Scott Herman
Title
President and Secretary
Phone
(903) 390-4040

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary
Chore ProviderGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 372500000X
Adult CompanionGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 372600000X
Attendant Care ProviderGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 3747A0650X
Personal Care AttendantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 3747P1801X
HomemakerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 376J00000X
Nurse's AideGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 376K00000X

Addresses

Primary practice location

1839 E Independence St Ste K
Springfield, MO 65804-3753

Mailing address

3450 N. Rock Rd.
#213 Attn: Debra Mullen
Witchita, KS 67226-1352
Phone (316) 688-5511

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Home Care LLC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1962793547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 N. ROCK RD.",
            "address_2": "#213 ATTN: DEBRA MULLEN",
            "city": "WITCHITA",
            "state": "KS",
            "postal_code": "672261352",
            "telephone_number": "316-688-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 E INDEPENDENCE ST STE K",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658043753",
            "telephone_number": "417-818-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-29",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT AND SECRETARY",
        "authorized_official_telephone_number": "903-390-4040"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "372500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.