Mississippi County Health Department
Organization Active NPI Public Health or Welfare Agency · Charleston, MO
NPI 1023210648 · NPPES record last updated Dec 7, 2023
Key facts
- NPI
- 1023210648
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- License
- 33173 (MO)
- Legal business name
- MISSISSIPPI COUNTY HEALTH DEPARTMENT
- Practice address
- 1200 E Marshall St
Charleston, MO 63834-1336 - Phone
- (573) 683-2191
- Fax
- (573) 683-6539
- NPI assigned
- Jun 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Rachelle Johnson, RD, LD, CDE
- Title
- Administrator
- Phone
- (573) 683-2191
Practitioners 7
-
Rachelle Johnson, R.D
-
Paris Delani Robbins, RD,LD
-
Rebecca L Crowley-Kuykendall, RD LD CNSC
-
Katrina L. Dowell, LCSW
-
Myra Gunn, RD
-
Jimmy D. Heath Jr., M.D.
-
Natalia Rose Mainord-Cannon, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080401000109 | MO | Part B Supplier - Mass Immunization (Roster Biller Only) | 1951330984 | Practice locations: Charleston, MO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | 33173 | MO | Yes |
| Public Health or Welfare Agency | 251K00000X | 126551 | MO |
Addresses
Primary practice location
1200 E Marshall St
Charleston, MO 63834-1336
Mailing address
1200 E Marshall St
Charleston, MO 63834-1336
Phone (573) 683-2191
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 425384823 | Medicaid | MO | |
| 209992403 | Medicaid | MO | |
| 357290501 | Medicaid | MO |
Other names
- Mississippi County Health Department
Other providers in Charleston, MO
- Alexandra J Majors
- Marion Eye Centers, LTD.
- Sherri Lynn McDonald
- Sharon Leslie McGhee
- Mississippi County Ambulance District
- Mississippi County Health Department
- Missouri Delta Medical Center
- N & R Charleston LLC
- N & R of Charleston LLC
- Benjamin Paynter
All providers in Charleston, MO · Public Health or Welfare Agency in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.