MEDICARE: TEARA MAYNARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	385H00000X	Respite Care
3	374U00000X	Home Health Aide
4	313M00000X	Nursing Facility/Intermediate Care Facility
5	314000000X	Skilled Nursing Facility
6	332BX2000X	Oxygen Equipment & Supplies (DME)
7	146D00000X	Personal Emergency Response Attendant
8	376J00000X	Homemaker
9	3747P1801X	Personal Care Attendant
10	311500000X	Alzheimer Center (Dementia Center)
11	251J00000X	Nursing Care Agency
12	3747A0650X	Attendant Care Provider
13	251E00000X	Home Health Agency
14	373H00000X	Day Training/Habilitation Specialist
15	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1043173743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEARA MAYNARD

Provider Business Mailing Address
First Line	:	4021 CHESTNUT AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130-1331
Country	:	US
Telephone Number	:	816-698-2308
Fax Number	:

Provider Business Practice Location Address
First Line	:	4021 CHESTNUT AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130-1331
Country	:	US
Telephone Number	:	816-698-2308
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/09/2025

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Directions to “ TEARA MAYNARD ” Practice Location

Language	Start Address	Practice Location

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