FCC Medical Clinics LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

FCC MEDICAL CLINICS LLC

Doing business as

FCC Primary Care Clinic

Practice address

900 State Route VV
Kennett, MO 63857-3834

Phone

(573) 559-2365

Fax

(573) 559-2357

NPI assigned

Jun 22, 2021

Last updated

Jun 22, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

FAMILY COUNSELING CENTER, INCAs reported in NPPES

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

Authorized official

Name

Tracy Ellis

Title

Cco

Phone

(573) 888-5925

Specialties & licenses 1

Addresses

Other names 1

• FCC Primary Care Clinic Doing business as

Tax ID family

FCC Medical Clinics LLC2 organizations share this tax ID, including this one

Part of

Family Counseling Cente

Other organizations with this tax ID 1

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

• FCC Medical Clinics LLC

  dba FCC Primary Care Clinic Poplar Bluff

  • Internal Medicine Physician
  • Poplar Bluff, MO
  • NPI 1215510490
  NPD tax ID

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1063081263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638570071",
            "telephone_number": "573-559-2365",
            "fax_number": "573-559-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 STATE ROUTE VV",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573834",
            "telephone_number": "573-559-2365",
            "fax_number": "573-559-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FCC MEDICAL CLINICS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY COUNSELING CENTER, INC",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "573-888-5925"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FCC Primary Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Family Counseling Center, Inc.
• Family Counseling Center, Inc.
• Family Counsiling Center
• Tara Beth Farrell, BS
• FCC Medical Clinics LLC (FCC Primary Care Clinic)
• Monica Featherston
• Tilghman J Feeler, LPC
• Emillie Finley
• Garry Finn, LMSW
• Brittany Paige Fisher

• Clinic/Center in Kennett, MO
• Providers in Kennett, MO by specialty
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.