Support Independence LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SUPPORT INDEPENDENCE LLC

Practice address

625 Loyola Dr
Florissant, MO 63031-7231

Phone

(314) 504-1459

NPI assigned

Mar 11, 2016

Last updated

Mar 11, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Timothy Shontez Macon

Title

Ceo/Owner

Phone

(314) 504-1459

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1982065454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 LOYOLA DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630317231",
            "telephone_number": "314-504-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 LOYOLA DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630317231",
            "telephone_number": "314-504-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORT INDEPENDENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "MACON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "SHONTEZ",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "314-504-1459"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Marie Sturm, MD
• Gregory A Stynowick, MD
• Mark Daniel Sueoka, DDS
• Tipu Sultan, M.D.
• Mikkaela Suntrup, PTA
• Support Innovations Inc.
• Support Innovations Plus
• Supportive Living Consumer Direct
• Cedric Lorenzo Sutton
• SVS Vision Inc

• Home Health Agency in Florissant, MO
• Providers in Florissant, MO by specialty
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.