Active NPI
Waynemedical Center LLC Lab
- Clinical Medical Laboratory
- Piedmont, MO
National Provider Identifier
1134104789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- WAYNEMEDICAL CENTER LLC LAB
- Practice address
- RR 4 Box 4515
Piedmont, MO 63957-9417 - Phone
- (573) 223-4233
- Fax
- (573) 223-2136
- NPI assigned
- Dec 7, 2005
- Last updated
- Jun 16, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. David A Gayle, M.D.
- Title
- Director
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 701080608 | Medicaid | MO |
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Family Medicine Physician
- Piedmont, MO
- NPI 1992792329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213574400000",
"number": "1134104789",
"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": "WAYNEMEDICAL CENTER LLC LAB",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-07",
"last_updated": "2008-06-16",
"status": "A",
"authorized_official_last_name": "GAYLE",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "573-223-4233",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "701080608",
"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 Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.