HEDRICK MEDICAL CENTER HOME HEATH AGENCY (THE GRAND RIVER HEALTH SYSTEM CORPORATION) NPI 1003001769
Registered Nurse (Community Health) in Chillicothe, MO
About HEDRICK MEDICAL CENTER HOME HEATH AGENCY (THE GRAND RIVER HEALTH SYSTEM CORPORATION)
Hedrick Medical Center Home Heath Agency (the Grand River Health System Corporation) is a provider established in Chillicothe, Missouri specializing in registered nurse. The NPI number of Hedrick Medical Center Home Heath Agency (the Grand River Health System Corporation) is 1003001769 and was assigned on September 2007. The practitioner's primary taxonomy code is 163WC1500X. The provider is registered as an organization and their NPI record was last updated 12 years ago. Hedrick Medical Center Home Heath Agency (the Grand River Health System Corporation) operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Hedrick Medical Center Home Heath Agency. The authorized official of this NPI record is Brian J Johnston (Ceo)
| NPI | 1003001769 |
| Provider Name | HEDRICK MEDICAL CENTER HOME HEATH AGENCY (THE GRAND RIVER HEALTH SYSTEM CORPORATION) |
| Provider Location Address | 498 PARK LN CHILLICOTHE, MO 64601 |
| Provider Mailing Address | 498 PARK LN CHILLICOTHE, MO 64601 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Other Organization Name | HEDRICK MEDICAL CENTER HOME HEATH AGENCY |
| Other Name Type | Doing Business As (3) |
| Enumeration Date | 09-06-2007 |
| Last Update Date | 07-15-2008 |
Primary Taxonomy
| Taxonomy Code | 163WC1500X |
| Classification | Registered Nurse |
| Type | Nursing Service Providers |
| Specialization | Community Health |
Business Address
HEDRICK MEDICAL CENTER HOME HEATH AGENCY
498 PARK LN
CHILLICOTHE, MO
ZIP 64601
Phone: (660) 646-2199
Mailing Address
HEDRICK MEDICAL CENTER HOME HEATH AGENCY
498 PARK LN
CHILLICOTHE, MO
ZIP 64601
Phone: (660) 646-2199
Group Taxonomy
193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | No | |||
Taxonomy Description: an individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. | |||||||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State |
|---|---|---|
| 941965303 | MEDICAID (05) | MO |
Other Providers at the same location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1245274653 | SAINT LUKES HOSPITAL OF CHILLICOTHE Organization | Hospice Care, Community Based | 498 PARK LN CHILLICOTHE, MO 64601 (660) 646-2199 |
| 1366637027 | THE GRAND RIVER HEALTH SYSTEM CORPORATION Organization | Homemaker | 498 PARK LN CHILLICOTHE, MO 64601 (660) 646-2199 |
| 1437353687 | MRS. TINA MARIE JONES P.T. Individual | Physical Therapist | 498 PARK LN CHILLICOTHE, MO 64601 (660) 707-4263 |
| 1457546111 | GRAND RIVER HEALTH SYSTEM CORPORATION Organization | Technician (Personal Care Attendant) | 498 PARK LN CHILLICOTHE, MO 64601 (660) 646-2199 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.