Organization Active NPI

Pulaski County Health Department

  • Public Health or Welfare Agency
  • Waynesville, MO
National Provider Identifier
1306932108
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
PULASKI COUNTY HEALTH DEPARTMENT
Doing business as
Pulaski County Health Center
Practice address
104 Ashley May St
Waynesville, MO 65583-3440
Phone
(737) 743-8205
Fax
(573) 774-3375
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Authorized official

Name
Mrs. Deborah Decker
Title
Director
Phone
(573) 774-3820

Specialties & licenses 1

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

Addresses

Primary practice location

104 Ashley May St
Waynesville, MO 65583-3440

Mailing address

PO Box 473
Waynesville, MO 65583-0473
Phone (573) 774-3820

Other identifiers 1

IdentifierTypeStateIssuer
511130908MedicaidMO

Other names 1

  • Pulaski County Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050308000865 MO Part B Supplier - Mass Immunization (Roster Biller Only) 9234113457 Practice locations: Crocker, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0691775Pulaski County Health Department104 Ashley May St, Waynesville, MO 65583Certificate of waiverNov 14, 2027

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

101 12th St
Crocker, MO 65452
Phone (573) 736-2217

104 Ashley May St
Ste 102
Waynesville, MO 65583

104 Ashley May St
Waynesville, MO 65583
Phone (737) 743-8205

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1306932108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 473",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655830473",
            "telephone_number": "573-774-3820",
            "fax_number": "573-774-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ASHLEY MAY ST",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655833440",
            "telephone_number": "737-743-8205",
            "fax_number": "573-774-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULASKI COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "573-774-3820",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "511130908",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pulaski County Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waynesville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.