INTREPID OF MISSOURI, INC. (NPI# 1245597285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245597285 |
| Entity Type | Organization |
| Organization Name | INTREPID OF MISSOURI, INC. |
| Other Organization Name | INTREPID USA HOSPICE |
| Practice Address |
4305 S. National Ave. Springfield MO 65810 |
| Mailing Address |
3220 Keller Springs Rd Ste 108 Carrollton TX 75006-5911 |
| Practice Telephone | 4178820614 |
| Practice Fax Number | 4178233071 |
| Mailing Telephone | 2144453750 |
| Mailing Fax Number | 2144453900 |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2019-04-03 |
| Authorized Official Name | JOHN M KUNYSZ JR. (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2144453750 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | Agencies |
| Other Name | Type Code |
|---|---|
| Intrepid USA Hospice | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 550 N Spring Park Blvd, Mount Vernon, MO 657127841 | 4172334132 | 4172107436 |
| Street Address |
4305 S. NATIONAL AVE. |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508373838 | Sunterra Springfield Oc, LLC | Skilled Nursing Facility | 4935 S National Ave, Springfield, MO 65810 | 2018-01-09 |
| 1982119392 | Boyoung Park | Specialist/Technologist | 4355 S National Ave Apt 905, Springfield, MO 65810 | 2017-12-07 |
| 1578086310 | Missouri Telerad LLC | Radiology | 5117 South Neffleton Avenue, Springfiled, MO 65810 | 2017-07-24 |
| 1700199668 | Telerad of Mo Account Management, LLC | Radiology | 5117 S. Neffleton Ave, Springfield, MO 65810 | 2010-07-21 |
| 1427286251 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 745 W El Camino Alto Drive, Springfield (s), MO 65810 | 2009-07-01 |
| 1033344304 | Teresa Mary Kaelin | Occupational Therapist | 3291 W. Ridge Run, Springfield, MO 65810 | 2009-05-15 |
| 1538366448 | Rani K Nair | Internal Medicine | 3231 S National Mercy Endocrineology, Ste 440, Springfield, MO 65810 | 2007-07-03 |
| 1467672519 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 4955 S. National Ave., Unit A, Springfield, MO 65810 | 2007-04-30 |
| 1336161983 | Leo Allan Tokarczyk | Dentist | 4777 S National Ave, Springfield, MO 65810 | 2006-07-24 |
| 1669433629 | Quail Creek Skilled Nursing, LLC | Skilled Nursing Facility | 1514 West Lark, Springfield, MO 65810 | 2006-03-30 |
| Find all providers in zip 65810 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023513058 | Prospect Crozer Home Health and Hospice, LLC | Hospice Care, Community Based | 200 W. Sroul Road, Springfield, PA 19064 | 2018-03-30 |
| 1215391065 | Great Lakes Caring Hospice C Il, LLC | Hospice Care, Community Based | 3085 Stevenson Dr Ste 200a, Springfield, IL 62703-4440 | 2016-04-07 |
| 1811393564 | Loving Peace Hospice, Inc. | Hospice Care, Community Based | 2815 Old Jacksonville Rd Ste 202, Springfield, IL 62704-6419 | 2014-11-07 |
| 1508012204 | Beacon Hospice, LLC | Hospice Care, Community Based | 815 Worcester St, Springfield, MA 01151-1001 | 2008-08-13 |
| 1720255284 | Good Shepherd Hospice of Springfield, LLC | Hospice Care, Community Based | 3250 S National Ave, Springfield, MO 65807-7303 | 2008-05-14 |
| 1710159355 | Omega Health Care of Southwest Missouri Inc | Hospice Care, Community Based | 2041 S Stewart Ave, Springfield, MO 65804-2522 | 2008-03-24 |
| 1083787840 | Southeast Colorado Hospital District | Hospice Care, Community Based | 200 E 10th Ave, Springfield, CO 81073-1621 | 2006-11-17 |
| 1699850180 | Northcrest Medical Center | Hospice Care, Community Based | 101e Mooreland Drive, Springfield, TN 37172-3974 | 2006-10-25 |
| 1366450504 | Hospice & Palliative Care Of | Hospice Care, Community Based | 2432 East Madrid Ave, Springfield, MO 65804 | 2006-08-04 |
| 1578500823 | Southerncare Inc | Hospice Care, Community Based | 777 E Battlefield St, Ste 104a, Springfield, MO 65807-4807 | 2006-06-02 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65810 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.