OMEGA LONG TERM CARE LLC (NPI# 1285042184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285042184 |
| Entity Type | Organization |
| Organization Name | OMEGA LONG TERM CARE LLC |
| Practice Address |
12800 Boenker Ln Bridgeton MO 63044-2438 |
| Practice Telephone | 3145510338 |
| Practice Fax Number | 3145510336 |
| Mailing Telephone | 3145510338 |
| Mailing Fax Number | 3145510336 |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-07-24 |
| Authorized Official Name | MRS. KIM L WYATT (OFFICE MANAGER) |
| Authorized Official Telephone | 3148085083 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 137743 | MO | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 207937715 | 05 | |
| MO | 2001189801 | 05 | |
| MO | 2083138069 | 05 | |
| MO | 429398209 | 05 |
| Street Address |
12800 BOENKER LN |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-2438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649220104 | Andrea E Ivy | Nurse Practitioner | 12800 Boenker Ln, Bridgeton, MO 63044-2438 | 2006-05-12 |
| 1568072650 | Yam Medical Center LLC | Nurse Practitioner | 12800 Boenker Ln, Bridgeton, MO 63044-2438 | 2020-08-04 |
| 1457985178 | Yam Home Health LLC | Home Health | 12800 Boenker Ln, Bridgeton, MO 63044-2438 | 2020-03-03 |
| 1932628807 | Nutressa Monroe | Nurse Practitioner | 12800 Boenker Ln, Bridgeton, MO 63044-2438 | 2017-09-12 |
| 1922470889 | Tina Ryan | Nurse Practitioner | 12800 Boenker Ln, Bridgeton, MO 63044 | 2015-10-30 |
| 1245652924 | Bridgeton Geriatrics LLC | Family Medicine | 12800 Boenker Ln, Bridgeton, MO 63044-2438 | 2014-01-14 |
| 1730259888 | Doctors Group, PC | Internal Medicine | 12800 Boenker Ln, Bridgeton, MO 63044-2438 | 2006-11-08 |
| 1841303310 | Khaled R Hassan | Internal Medicine | 12800 Boenker Ln, Bridgeton, MO 63044-2438 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508056425 | Mizpah Assisted Living Services | Assisted Living Facility | 11325 Saint Charles Rock Rd, Bridgeton, MO 63044-2722 | 2007-07-26 |
| 1205952744 | Assisted Living Concepts Inc | Assisted Living Facility | 18 Reeves Road, Bridgeton, NJ 08302 | 2007-03-22 |
| 1700263910 | Hw/weidco/ren LLC | Assisted Living Facility | 99 Manheim Ave, Bridgeton, NJ 08302-2114 | 2015-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820283 | Oak Meadows Rcf LLC | Assisted Living Facility | 5502 Misty Meadow Rd, Poplar Bluff, MO 63901-9287 | 2020-10-28 |
| 1700486859 | Hillcrest Residential Care | Assisted Living Facility | 9415 N North Browns Station Rd, Columbia, MO 65202-8671 | 2020-10-28 |
| 1700484250 | Americare At Field Pointe LLC | Assisted Living Facility | 5002 Gene Field Road, St Joseph, MO 64506 | 2020-10-15 |
| 1205433638 | Skyline Assisted Living LLC | Assisted Living Facility | 100 Hard Rock Rd, Van Buren, MO 63965-0780 | 2020-10-08 |
| 1023615622 | Four Seasons Care Corp | Assisted Living Facility | 230 Railroad St, Moscow Mills, MO 63362-1600 | 2020-10-06 |
| 1336754985 | Tiffany Springs Senior Care Community | Assisted Living Facility | 9101 N Ambassador Dr, Kansas City, MO 64154-7295 | 2020-09-10 |
| 1366053480 | Green Acres Assisted Living LLC | Assisted Living Facility | 411 N Kings Highway, Sikeston, MO 63801-1936 | 2020-08-12 |
| 1467062612 | Welcome Home Assisted Living, LLC | Assisted Living Facility | 5 Adams Dr, Dexter, MO 63841-1985 | 2020-08-03 |
| 1831725142 | Harmony Gardens Residential, LLC | Assisted Living Facility | 539 E Young Ave, Warrensburg, MO 64093-1228 | 2020-03-18 |
| 1386278414 | Family Partners Home LLC | Assisted Living Facility | 232 Creve Coeur Ave, Manchester, MO 63011-4040 | 2020-02-27 |
| Find all providers with the same taxonomy | ||||
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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.