KATY TRAIL - DENTAL - WARSAW – NPI #1144538562
Clinic/Center

KATY TRAIL - DENTAL - WARSAW is an AHC clinic located in WARSAW, MO. NPPES has assigned the NPI number 1144538562 to KATY TRAIL - DENTAL - WARSAW on September 20, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “KATY TRAIL - DENTAL - WARSAW” is a dba name, the actual legal business name for this organization is REGIONAL HEALTH CARE CLINIC. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 2 years ago on Feb 21, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KATY TRAIL - DENTAL - WARSAW below.

NPI Profile for
REGIONAL HEALTH CARE CLINIC

NPI Number
1144538562
Enumeration Date

(more than 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
REGIONAL HEALTH CARE CLINIC
Doing Business As (dba): KATY TRAIL - DENTAL - WARSAW
Primary location
17571 N DAM ACCESS RD
WARSAW, MO 65355-6396
Phone: (660) 438-2595 Fax: (660) 438-2313
Mailing address
821 WESTWOOD DR
SEDALIA, MO 65301-2102
Phone: (660) 826-4774 Fax: (660) 826-1300
Organization Subpart
No
Authorized Official
MICHAEL WALLER
CEO
Phone: (660) 438-2717
Updated
Certification Date
Feb 21, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for KATY TRAIL - DENTAL - WARSAW

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMO509079208
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.