Organization Active NPI

A to Z Wellness and Rehab Services, LLC

  • Home Health Agency
  • Poplar Bluff, MO
National Provider Identifier
1992004386
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
A TO Z WELLNESS AND REHAB SERVICES, LLC
Practice address
600 Vine St
Poplar Bluff, MO 63901-5039
Phone
(573) 776-6100
Fax
(573) 776-6123
NPI assigned
Mar 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Amy ManchesterNPI 1780864330
Title
Ceo
Phone
(573) 776-6100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X

Addresses

Primary practice location

600 Vine St
Poplar Bluff, MO 63901-5039

Mailing address

600 Vine St
Poplar Bluff, MO 63901-5039
Phone (573) 776-6100

Other names 1

  • Sunrise Home Care, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230626000703 IA Part A Provider - Home Health Agency 5496113375 Practice locations: Poplar Bluff, MO

Home health agency certification: CCN 267634

Legal name
A TO Z WELLNESS AND REHAB SERVICES LLC
Doing business as
SUNRISE HOME CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 2, 2012
Last certification
Jun 30, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Mar 7, 2013 in MO
Enrollment address
600 Vine St
Poplar Bluff, MO 63901-5039

Care Compare: Home health agency

Medicare Care Compare
Listed as
Sunrise Home Care, LLCCCN 267634
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Jul 2, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

4061 Highway PP
Ste 3
Poplar Bluff, MO 63901
Phone (573) 776-6100

600 Vine St
Poplar Bluff, MO 63901
Phone (573) 776-6100

1227 Sterling Dr
Poplar Bluff, MO 63901
Phone (573) 776-6100

2210 Barron Rd
#215
Poplar Bluff, MO 63901
Phone (573) 776-6100

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Amy Manchester Individual 5% Or Greater Direct Ownership Interest May 1, 2024 51%
Corporate OfficerCeo / Administrator Mar 20, 2023
Corporate DirectorCeo / Board Member / Administrat Mar 20, 2023
W-2 Managing EmployeeAd; Mar 20, 2023
David Byrne Individual 5% Or Greater Direct Ownership Interest May 1, 2024 49%

Change-of-ownership history 2

DateEventCounterparty
Mar 20, 2023 Change of OwnershipThis provider was the buyer Sunrise Home Care LLCCCN 267634, MO, NPI 1992004386
Mar 20, 2023 Change of OwnershipThis provider was the seller Sunrise Home Care LLCCCN 267634, IA, NPI 1992004386

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1992004386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 VINE ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015039",
            "telephone_number": "573-776-6100",
            "fax_number": "573-776-6123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 VINE ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015039",
            "telephone_number": "573-776-6100",
            "fax_number": "573-776-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A TO Z WELLNESS AND REHAB SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "MANCHESTER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-776-6100"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Home Care, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.