Organization Active NPI

Randolph County Health Department

  • Rural Health Clinic/Center
  • Moberly, MO
National Provider Identifier
1194805267
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
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

Updated by the provider on Jul 21, 2022

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1194805267MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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

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.

Verify at the official NPI Registry.