Springfield Healthcare Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

036662 Issued in MO

Legal business name

SPRINGFIELD HEALTHCARE CENTER LLC

Practice address

2401 W Grand St
Springfield, MO 65802-4967

Phone

(417) 864-4545

Fax

(417) 869-4524

NPI assigned

Jun 17, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Robert W. Redman

Title

Owner

Phone

(816) 415-9700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Springfield Skilled Care Center Doing business as

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1982831996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 LIBERTY DR",
            "city": "PLEASANT VALLEY",
            "state": "MO",
            "postal_code": "640687757",
            "telephone_number": "816-415-9700",
            "fax_number": "816-415-9770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W GRAND ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658024967",
            "telephone_number": "417-864-4545",
            "fax_number": "417-869-4524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-17",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "REDMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-415-9700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "036662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102500303",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springfield Skilled Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Springfield Eyecare, LLC
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• Springfield Group Inc
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• Springfield Hearing Aid Center
• Springfield Hearing Aid Center
• Springfield Hearing Center
• Springfield Hearing Center

• Skilled Nursing Facility in Springfield, MO
• Providers in Springfield, 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 Jun 17, 2009; 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.