NPIMap

Organization Active NPI

Marion County Health Dept & Home Health Agency

  • Public Health or Welfare Agency
  • Hannibal, MO
National Provider Identifier
1285046037
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
2004008342 Issued in MO
Legal business name
MARION COUNTY HEALTH DEPT & HOME HEALTH AGENCY
Practice address
3105 Palmyra Rd
Hannibal, MO 63401-2203
Phone
(573) 221-1166
Fax
(573) 221-1214
NPI assigned
May 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Authorized official

Name
Mrs. Candice Renee Gottman, RN
Title
Registered Nurse
Phone
(573) 221-1166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 2004008342 MO Primary

Addresses

Primary practice location

3105 Palmyra Rd
Hannibal, MO 63401-2203

Mailing address

3105 Palmyra Rd
Hannibal, MO 63401-2203
Phone (573) 221-1166

Other identifiers 1

IdentifierTypeStateIssuer
510622004MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Marion County Health Dept Home Health Agency7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3105 Palmyra Rd
Hannibal, MO 63401
Phone (573) 221-1166

NPI Registry JSON

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401235200000",
    "number": "1285046037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 PALMYRA RD",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634012203",
            "telephone_number": "573-221-1166",
            "fax_number": "573-221-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 PALMYRA RD",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634012203",
            "telephone_number": "573-221-1166",
            "fax_number": "573-221-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION COUNTY HEALTH DEPT & HOME HEALTH AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-28",
        "last_updated": "2014-05-28",
        "status": "A",
        "authorized_official_last_name": "GOTTMAN",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "REGISTERED NURSE",
        "authorized_official_telephone_number": "573-221-1166",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "MO",
            "license": "2004008342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "510622004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; 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.