NPIMap

Organization Active NPI

Dedicated Missouri Holding, LLC

  • Non-Pharmacy Dispensing Site
  • Independence, MO
National Provider Identifier
1992451868
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
DEDICATED MISSOURI HOLDING, LLC
Practice address
1010 W US Highway 24
Independence, MO 64050-2337
Phone
(816) 608-2921
Fax
(816) 608-3411
NPI assigned
Mar 1, 2022
Organization subpart
Yes
Parent organization
DEDICATED MISSOURI HOLDING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Authorized official

Name
Mary Chen
Title
Authorized Official
Phone
(305) 628-6117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

1010 W US Highway 24
Independence, MO 64050-2337

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (305) 628-6117

Other names 1

  • DEDICATED SENIOR MEDICAL CENTER INDEPENDENCE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dedicated Missouri HLDG LLC6 organizations share this tax ID, including this one
Part of
Dedicated Missouri HLDG LLC

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1992451868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W US HIGHWAY 24",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640502337",
            "telephone_number": "816-608-2921",
            "fax_number": "816-608-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED MISSOURI HOLDING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEDICATED MISSOURI HOLDING, LLC",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "305-628-6117"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEDICATED SENIOR MEDICAL CENTER INDEPENDENCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.