{
"Npi": {
"NPI": "1215191598",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "AMEDISYS MISSOURI, L.L.C.",
"ParentOrgTIN": null,
"OrgName": "AMEDISYS MISSOURI, L.L.C.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3854 AMERICAN WAY",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "BATON ROUGE",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70816-4013",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "225-292-2031",
"MailingAddressFaxNumber": "225-295-9678",
"FirstLinePracticeLocationAddress": "800 NE 291 HWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LEES SUMMIT",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "64086-5530",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "816-524-7355",
"PracticeLocationAddressFaxNumber": "816-524-7354",
"EnumerationDate": "07/15/2008",
"LastUpdateDate": "07/24/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MIGLICCO",
"AuthorizedOfficialFirstName": "TRAVIS",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SVP TAX",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "225-299-3803",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "827-2HH",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "827-3HH",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "827-4HH",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "827-7HH",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}