Organization Active NPI

Lincoln County Health Department

  • Community Health Registered Nurse
  • Troy, MO
National Provider Identifier
1659366417
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
053723 Issued in MO
Legal business name
LINCOLN COUNTY HEALTH DEPARTMENT
Practice address
5 Health Department Dr
Troy, MO 63379-4551
Phone
(636) 528-6117
Fax
(636) 528-8629
NPI assigned
Sep 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Authorized official

Name
Mr. Brett Siefert
Title
Administrator
Phone
(636) 528-6117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WC1500X 053723 MO Primary

Addresses

Primary practice location

5 Health Department Dr
Troy, MO 63379-4551

Mailing address

5 Health Department Dr
Troy, MO 63379-4551
Phone (636) 528-6117

Other identifiers 1

IdentifierTypeStateIssuer
511575201MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080414000464 MO Part B Supplier - Mass Immunization (Roster Biller Only) 7416983135 Practice locations: Troy, 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
26D0441347Lincoln County Health Department#5 Health Department Drive, Troy, MO 63379Certificate of waiverFeb 16, 2027

National Provider Directory

National Provider Directory

Locations

5 Health Department Dr
Troy, MO 63379
Phone (636) 528-6117

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349913600000",
    "number": "1659366417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HEALTH DEPARTMENT DR",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633794551",
            "telephone_number": "636-528-6117",
            "fax_number": "636-528-8629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HEALTH DEPARTMENT DR",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633794551",
            "telephone_number": "636-528-6117",
            "fax_number": "636-528-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2012-10-11",
        "status": "A",
        "authorized_official_last_name": "SIEFERT",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "636-528-6117",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "MO",
            "license": "053723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "511575201",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.