Active NPI
Randolph County Health Department
- Rural Health Clinic/Center
- Moberly, MO
National Provider Identifier
1194805267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Health Clinic/Center
- Legal business name
- RANDOLPH COUNTY HEALTH DEPARTMENT
- Practice address
- 1319 E Highway 24
Moberly, MO 65270-3682 - Phone
- (660) 263-6643
- Fax
- (660) 263-0333
- NPI assigned
- Oct 16, 2006
- 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
- Sharon Whisenand
- Title
- Chief Financial Officer
- Phone
- (660) 263-6643
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Primary | ||
| Rural Health Clinic/Center | 261QR1300X | MO |
Addresses
Primary practice location
1319 E Highway 24
Moberly, MO 65270-3682
Mailing address
1319 E Highway 24
Moberly, MO 65270-3682
Phone (660) 263-6643
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194805267 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090504000374 | MO | Part B Supplier - Clinic/Group Practice | 9638182413 |
Receives reassigned benefits from 1 practitioner 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Moberly, MO |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Public Health or Welfare Agency
- Moberly, MO
- NPI 1194990713
O20090504000374
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Public Health or Welfare Agency
- Moberly, MO
- NPI 1194990713
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1194805267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1319 E HIGHWAY 24",
"city": "MOBERLY",
"state": "MO",
"postal_code": "652703682",
"telephone_number": "660-263-6643",
"fax_number": "660-263-0333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1319 E HIGHWAY 24",
"city": "MOBERLY",
"state": "MO",
"postal_code": "652703682",
"telephone_number": "660-263-6643",
"fax_number": "660-263-0333"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RANDOLPH COUNTY HEALTH DEPARTMENT",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-16",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "WHISENAND",
"authorized_official_first_name": "SHARON",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "660-263-6643"
},
"taxonomies": [
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QR1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rural Health",
"state": "MO",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1194805267",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Moberly, MO
- Courtney Ramsey, NP
- Randolph County Ambulance District
- Randolph County Caring Community, Inc (Randolph County Caring Community Partnership)
- Randolph County Developmental Disability Resources (Randolph County Developmental Disability Services)
- Randolph County Developmental Disability Services
- Randolph County Health Department
- Randolph County Health Department
- Randolph County Health Department
- Randolph County Health Department
- Randolph County Health Department
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.