Organization Active NPI

Perry County Health Department

  • Public Health or Welfare Agency
  • Perryville, MO
National Provider Identifier
1922095025
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
PERRY COUNTY HEALTH DEPARTMENT
Practice address
406 N Spring St
Suite #1
Perryville, MO 63775-1935
Phone
(573) 547-6564
Fax
(573) 547-3908
NPI assigned
Oct 4, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Authorized official

Name
Mrs. Judy Marie Laurentius
Title
Administrator
Phone
(573) 547-6564

Specialties & licenses 1

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

Addresses

Primary practice location

406 N Spring St
Suite #1
Perryville, MO 63775-1935

Mailing address

406 N Spring St
Suite #1
Perryville, MO 63775-1935
Phone (573) 547-6564

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111028000627 MO Part B Supplier - Mass Immunization (Roster Biller Only) 3476726910 Practice locations: Perryville, MO

National Provider Directory

National Provider Directory

Locations

406 N Spring St
Ste 1
Perryville, MO 63775
Phone (573) 547-6564

Practitioners & affiliated clinicians

Practitioners 1

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": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1922095025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 N SPRING ST",
            "address_2": "SUITE #1",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751935",
            "telephone_number": "573-547-6564",
            "fax_number": "573-547-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N SPRING ST",
            "address_2": "SUITE #1",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751935",
            "telephone_number": "573-547-6564",
            "fax_number": "573-547-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "LAURENTIUS",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-547-6564",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perryville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; 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.