NPIMap

Organization Active NPI

Professional Home Health Agency LLC

  • Home Health Agency
  • Saint Peters, MO
National Provider Identifier
1992783732
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
267593 Issued in MO
Legal business name
PROFESSIONAL HOME HEALTH AGENCY LLC
Practice address
2730 S Saint Peters Pkwy
Suite 300
Saint Peters, MO 63303-5677
Phone
(636) 946-5051
Fax
(636) 946-5039
NPI assigned
Jan 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Authorized official

Name
Malik S Karim
Title
Ceo
Phone
(636) 946-5051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 267593 MO Primary

Addresses

Primary practice location

2730 S Saint Peters Pkwy
Suite 300
Saint Peters, MO 63303-5677

Mailing address

2730 S Saint Peters Pkwy
Suite 300
Saint Peters, MO 63303-5677
Phone (636) 946-5051

Other identifiers 1

IdentifierTypeStateIssuer
586221509MedicaidMO

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2730 S Saint Peters Pkwy
Ste 300
Saint Peters, MO 63303
Phone (636) 946-5051

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1992783732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 S SAINT PETERS PKWY",
            "address_2": "SUITE 300",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633035677",
            "telephone_number": "636-946-5051",
            "fax_number": "636-946-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 S SAINT PETERS PKWY",
            "address_2": "SUITE 300",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633035677",
            "telephone_number": "636-946-5051",
            "fax_number": "636-946-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HOME HEALTH AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-03",
        "last_updated": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "KARIM",
        "authorized_official_first_name": "MALIK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "636-946-5051"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "267593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "586221509",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.