NPIMap

Organization Active NPI

Wayne Medical Center LLC

  • Rural Health Clinic/Center
  • Piedmont, MO
National Provider Identifier
1083775860
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
263933 Issued in MO
Legal business name
WAYNE MEDICAL CENTER LLC
Practice address
RR 4 Box 4515
Piedmont, MO 63957-9417
Phone
(573) 223-4233
Fax
(573) 223-2136
NPI assigned
Dec 13, 2006
Last updated
Jan 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David Andrew Gayle, M.D.NPI 1992792329
Title
Member
Phone
(573) 223-4233

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 263933 MO Primary

Addresses

Primary practice location

RR 4 Box 4515
Piedmont, MO 63957-9417

Mailing address

RR 4 Box 4515
Piedmont, MO 63957-9417
Phone (573) 223-4233

Other identifiers 1

IdentifierTypeStateIssuer
595929902MedicaidMO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327017600000",
    "number": "1083775860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 4 BOX 4515",
            "city": "PIEDMONT",
            "state": "MO",
            "postal_code": "639579417",
            "telephone_number": "573-223-4233",
            "fax_number": "573-223-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 4 BOX 4515",
            "city": "PIEDMONT",
            "state": "MO",
            "postal_code": "639579417",
            "telephone_number": "573-223-4233",
            "fax_number": "573-223-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2012-01-20",
        "status": "A",
        "authorized_official_last_name": "GAYLE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "573-223-4233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MO",
            "license": "263933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "595929902",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Piedmont, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.