Organization Active NPI

Stoddard County Health Center

  • Public Health or Welfare Agency
  • Bloomfield, MO
National Provider Identifier
1619957313
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
STODDARD COUNTY HEALTH CENTER
Practice address
1001 Hwy 25 N
Bloomfield, MO 63825-0277
Phone
(573) 568-4593
Fax
(573) 568-4736
NPI assigned
Jan 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Rhonda Jean Shepard
Title
Office Assistant
Phone
(573) 568-4593

Specialties & licenses 1

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

Addresses

Primary practice location

1001 Hwy 25 N
Bloomfield, MO 63825-0277

Mailing address

PO Box 277
1001 Hwy 25 N
Bloomfield, MO 63825-0277
Phone (573) 568-4593

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150617002788 MO Part B Supplier - Mass Immunization (Roster Biller Only) 1850396623 Practice locations: Bloomfield, MO

National Provider Directory

National Provider Directory

Locations

1001 State Route 25 N
Bloomfield, MO 63825
Phone (573) 568-4593

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619957313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "address_2": "1001 HWY 25 N",
            "city": "BLOOMFIELD",
            "state": "MO",
            "postal_code": "638250277",
            "telephone_number": "573-568-4593",
            "fax_number": "573-568-4736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HWY 25 N",
            "city": "BLOOMFIELD",
            "state": "MO",
            "postal_code": "638250277",
            "telephone_number": "573-568-4593",
            "fax_number": "573-568-4736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STODDARD COUNTY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE ASSISTANT",
        "authorized_official_telephone_number": "573-568-4593",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.