Individual provider Active NPI

Rachel Dawn Pangburn, MSW, LCSW

  • Clinical Social Worker
  • Columbia, MO
National Provider Identifier
1265875736
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2011029968 Issued in MO
Practice address
1805 E Walnut St
Columbia, MO 65201-6425
Phone
(573) 777-7500
Fax
(573) 777-7505
NPI assigned
Apr 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2011029968 MO Primary

Addresses

Primary practice location

1805 E Walnut St
Columbia, MO 65201-6425

Mailing address

2885 W Battlefield St
Springfield, MO 65807-3952
Phone (417) 761-5214

Other identifiers 1

IdentifierTypeStateIssuer
490004359MedicaidMO

Other names 1

  • Rachel Dawn Lasley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130724000045 MO Practitioner - Clinical Social Worker 6800037466 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Burrell, Inc. CurrentSince Apr 14, 2025 Accepting new patients
Burrell, Inc. CurrentSince Apr 14, 2025 Accepting new patients

Locations

1805 E Walnut St
Columbia, MO 65201
Phone (573) 777-7500

1611 Towne Dr
Columbia, MO 65202
Phone (573) 229-9410

1300 E Bradford Pkwy
#H
Springfield, MO 65804

2885 W Battlefield St
Springfield, MO 65807
Phone (417) 761-5214

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1265875736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 W BATTLEFIELD ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658073952",
            "telephone_number": "417-761-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 E WALNUT ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016425",
            "telephone_number": "573-777-7500",
            "fax_number": "573-777-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGBURN",
        "first_name": "RACHEL",
        "middle_name": "DAWN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2011029968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490004359",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "LASLEY",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.