Organization Active NPI

Hickory County Health Department

  • Public Health or Welfare Agency
  • Hermitage, MO
National Provider Identifier
1750416251
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
HICKORY COUNTY HEALTH DEPARTMENT
Practice address
24885 State Hwy 254
Hermitage, MO 65668-0144
Phone
(417) 745-2138
Fax
(417) 745-2400
NPI assigned
Feb 23, 2007
Last updated
May 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Authorized official

Name
Mrs. Dawn Vader
Title
Administrator
Phone
(417) 745-2138

Specialties & licenses 1

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

Addresses

Primary practice location

24885 State Hwy 254
Hermitage, MO 65668-0144

Mailing address

PO Box 21
Hermitage, MO 65668-0021
Phone (417) 745-2138

Other identifiers 1

IdentifierTypeStateIssuer
511297202MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190613001986 MO Part B Supplier - Mass Immunization (Roster Biller Only) 5991884389 Practice locations: Hermitage, MO
O20240229001310 MO Part B Supplier - Clinic/Group Practice 5991884389 Receives reassigned benefits from 2 practitioners
Practice locations: Hermitage, MO

National Provider Directory

National Provider Directory

Locations

201 Cedar St
Hermitage, MO 65668
Phone (417) 745-2138

Practitioners & affiliated clinicians

Practitioners 3

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": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1750416251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21",
            "city": "HERMITAGE",
            "state": "MO",
            "postal_code": "656680021",
            "telephone_number": "417-745-2138",
            "fax_number": "417-745-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24885 STATE HWY 254",
            "city": "HERMITAGE",
            "state": "MO",
            "postal_code": "656680144",
            "telephone_number": "417-745-2138",
            "fax_number": "417-745-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKORY COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "VADER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "417-745-2138",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "511297202",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.