Montgomery County Health Department

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

25917 Issued in MO

Legal business name

MONTGOMERY COUNTY HEALTH DEPARTMENT

Practice address

400 Salisbury St
Montgomery City, MO 63361-1232

Phone

(573) 564-2495

Fax

(573) 564-5059

NPI assigned

Sep 21, 2005

Organization subpart

No

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

Authorized official

Name

Linda Harman

Title

Administrator

Phone

(573) 564-2495

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Home health agency certification: CCN 267093

Legal name

MONTGOMERY COUNTY HEALTH DEPARTMENT

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jan 5, 1982

Last certification

Apr 21, 2021

Ownership / control type

Proprietary

Organization structure

GovernmentNon-profit

Enrollment address

400 Salisbury St
Montgomery City, MO 63361-1232

Listed as

Montgomery County Health DepartmentCCN 267093 · All quality measures

Overall star rating

4 of 5

Ownership

Proprietary

Certified

Jan 5, 1982

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Tax ID family

Montgomery County Health Department2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Montgomery County Health Department

  • Public Health or Welfare Agency
  • Montgomery City, MO
  • NPI 1215440417
  NPD tax ID

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Mary Ellen Shanks, APRN,BC,FNP

  • Family Nurse Practitioner
  • Montgomery City, MO
  • NPI 1710293972

  Corporate Officer

  CMS ownership

Practitioners 1

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

• Mary Ellen Shanks, APRN,BC,FNP

  • Family Nurse Practitioner
  • Montgomery City, MO
  • NPI 1710293972
  NPD

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jessica Marie Haug, P.A.

  • Physician Assistant
  • Hermann, MO
  • NPI 1073811592

  Home health agency

  Care Compare affiliation
• Eric F. Kondro, M.D.

  • Family Medicine Physician
  • Montgomery City, MO
  • NPI 1336124023

  Home health agency

  Care Compare affiliation
• Eric Ryan Penton, MD

  • General Practice Physician
  • Hermann, MO
  • NPI 1942837562

  Home health agency

  Care Compare affiliation
• Chad J. Smith, D.O.

  • Family Medicine Physician
  • Warrenton, MO
  • NPI 1982600615

  Home health agency

  Care Compare affiliation
• Londa Y Swoboda, FNP, BSN, MSN

  • Nurse Practitioner
  • Montgomery City, MO
  • NPI 1851567762

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1902892375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SALISBURY ST",
            "city": "MONTGOMERY CITY",
            "state": "MO",
            "postal_code": "633611232",
            "telephone_number": "573-564-2495",
            "fax_number": "573-564-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SALISBURY ST",
            "city": "MONTGOMERY CITY",
            "state": "MO",
            "postal_code": "633611232",
            "telephone_number": "573-564-2495",
            "fax_number": "573-564-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HARMAN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-564-2495"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "25917",
            "primary": true
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "MO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "511670002",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "581670007",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCUSA",
            "identifier": "8475",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen M Johnson, LPT
• Eric F. Kondro, M.D.
• Gregory S. Link, MSW, LCSW
• Montgomery County Ambulance District
• Montgomery County Health Department
• Susan Mount
• Ms MGC Inc (Medicine Shoppe)
• Ms MGC Inc
• Thomas Robert Nichols, DDS
• Noble Health Audrain Inc (Audrain Com Clinic Montgomery)

• Home Health Agency in Montgomery City, MO
• Providers in Montgomery City, MO by specialty
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.