STATE OF MISSOURI (NPI# 1992871958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992871958 |
| Entity Type | Organization |
| Organization Name | STATE OF MISSOURI |
| Other Organization Name | SPRINGFIELD REGIONAL CENTER |
| Practice Address |
1515 E Pythian St Springfield MO 65802-2139 |
| Mailing Address |
1706 E Elm St Jefferson City MO 65101-4130 |
| Practice Telephone | 4178957400 |
| Practice Fax Number | 4178957412 |
| Mailing Telephone | 5737513398 |
| Mailing Fax Number | 5735264560 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-10-27 |
| Authorized Official Name | MOLLY JANE BOECKMANN (DIRECTOR OF ADMINISTRATIVE SERVICES) |
| Authorized Official Telephone | 5737514055 |
| Is Organization Subpart | Y |
| Parent Organization Name | STATE OF MISSOURI |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | EXEMPT | MO | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 851792804 | 05 |
| Other Name | Type Code |
|---|---|
| Springfield Regional Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437781499 | State of Missouri | Rehabilitation Counselor | 3418 Knipp Dr, Jefferson City, MO 65109-5701 | 2020-02-07 |
| 1275073280 | State of Missouri | General Practice | 1547 W Commerce Drive, Marshall, MO 65340-3907 | 2017-02-24 |
| 1528333085 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1000 N Colorado St, Nevada, MO 64772-1618 | 2012-03-16 |
| 1386843621 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15555 Little Blue Rd, Kansas City, MO 64139 | 2007-07-17 |
| 1922207679 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5410 Rinker Rd, Kansas City, MO 64129-2308 | 2007-07-13 |
| 1760681415 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1501 N River Blvd, Independence, MO 64050-1760 | 2007-07-13 |
| 1164630463 | State of Missouri | Intermediate Care Facility, Mentally Retarded | 11 Brady Cir, Overland, MO 63114-1110 | 2007-05-18 |
| 1548322605 | State of Missouri | Day Training, Developmentally Disabled Services | 1500 Vandiver Dr Ste 100, Columbia, MO 65202-3932 | 2006-12-15 |
| 1366503153 | State of Missouri | Day Training, Developmentally Disabled Services | 471 E Slater St, Marshall, MO 65340 | 2006-12-13 |
| 1427118033 | State of Missouri | Day Training, Developmentally Disabled Services | 522 Star St, Marshall, MO 65340 | 2006-12-12 |
| Street Address |
1515 E PYTHIAN ST |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65802-2139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225108962 | State of Missouri | Case Management | 1515 E Pythian St, Springfield, MO 65802-2139 | 2006-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454549 | Andrea Strauch | Counselor | 2024 W Chestnut Expressway Way, Springfield, MO 65802 | 2020-10-12 |
| 1962968867 | Chad Michael Linck | Specialist/Technologist | 2125 N Glenstone Ave, Springfield, MO 65802 | 2019-02-15 |
| 1790254647 | Meds To Live By | Pharmacist | 1134 N. Scarlett Way, Springfield, MO 65802 | 2018-11-21 |
| 1568945103 | Ficom | Non-Pharmacy Dispensing Site | 1308 North Glenstone Avenue, Springfield, MO 65802 | 2018-09-10 |
| 1982194775 | Karla Caballero | Marriage & Family Therapist | 8627 Montant Fort Way, 145, Sprinfield, MO 65802 | 2018-05-16 |
| 1780191809 | Tiffany Chawntay Coryell | Pharmacist | 1134 North Scarlett Way, Springfield, MO 65802 | 2018-01-10 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1407389596 | Medical Mile Imaging | Radiology | 3905 E Windsmore Dr, Springfield, MO 65802 | 2017-04-06 |
| 1346619103 | Jill A Knight | Occupational Therapist | 1601 E. Pythian, Green Valley State School, Springfield, MO 65802 | 2015-09-22 |
| 1447653258 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3720 E Sunshine St, Springfield, MO 65802 | 2014-10-07 |
| Find all providers in zip 65802 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841719689 | The Arc of Union County, Inc. | Day Training, Developmentally Disabled Services | 70 Diamond Rd # Dcf, Springfield, NJ 07081-3119 | 2017-09-13 |
| 1730608571 | The Arc of Union County, Inc. | Day Training, Developmentally Disabled Services | 70 Diamond Rd # Supports, Springfield, NJ 07081-3119 | 2017-09-13 |
| 1528419769 | Weber Care Corporation | Day Training, Developmentally Disabled Services | 2520 Saint James Rd, Springfield, IL 62707-9736 | 2016-06-29 |
| 1801244363 | Land of Lincoln Goodwill Industries | Day Training, Developmentally Disabled Services | 1220 Outer Park Dr, Springfield, IL 62704-4409 | 2016-05-25 |
| 1952775058 | Springfield Developmental Center | Day Training, Developmentally Disabled Services | 4595 Laverna Rd, Springfield, IL 62707-9732 | 2015-11-30 |
| 1245610310 | The Arc of Union County | Day Training, Developmentally Disabled Services | 54 Fadem Rd, Springfield, NJ 07081-3116 | 2015-06-04 |
| 1427438597 | The Arc of Union County | Day Training, Developmentally Disabled Services | 60 Diamond Rd, Springfield, NJ 07081-3114 | 2015-06-04 |
| 1902286214 | The Arc of Union County | Day Training, Developmentally Disabled Services | 70 Diamond Rd, Springfield, NJ 07081-3119 | 2015-06-02 |
| 1558798322 | Sunshine Village, Inc. | Day Training, Developmentally Disabled Services | 585 E. Columbus Ave, Springfield, MA 01103 | 2013-10-10 |
| 1720383789 | Rivendale Learning Institue | Day Training, Developmentally Disabled Services | 1613 W Elfindate Road, Springfield, MO 65807 | 2011-01-21 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65802 |
Please comment or provide details below to improve the information on STATE OF MISSOURI.
| 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.