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Ozark Tri-County Health Care Consortium

Organization Active NPI Federally Qualified Health Center (FQHC) · Neosho, MO

NPI 1114626652 · NPPES record last updated Aug 10, 2023

Key facts

NPI
1114626652
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
OZARK TRI-COUNTY HEALTH CARE CONSORTIUM
Practice address
1120 Carl Sweeney Rd
Neosho, MO 64850-7743
Phone
(417) 782-6200
Fax
(417) 782-6210
NPI assigned
Feb 23, 2023
Organization subpart
No

Authorized official

Name
Donald Michael McBride
Title
Ceo
Phone
(417) 451-9450

Owners & managing parties with NPI records 3

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 46

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

View all 46

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Federally qualified health center certification: CCN 261064

Legal name
OZARK TRI-COUNTY HEALTH CARE CONSORTIUM
Doing business as
ACCESS FAMILY CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 1, 2013
Last certification
Aug 1, 2013
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Enrollment address
1120 Carl Sweeney Pkwy
Neosho, MO 64850-7443

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Julia M Leibbrand
Individual 		W-2 Managing Employee
Provider Enrollment		 Aug 26, 2013
Robin a Chapman
Individual 		Corporate Director
Board Member		 Feb 23, 2023
Sheila R Long
Individual 		Corporate Officer
Cfo		 May 14, 2007
W-2 Managing Employee
Chief Financial Officer Cfo		 May 14, 2007
Amanda K Bearden
Individual 		Corporate Director
Board Member		 Aug 22, 2024
Keenan T Cortez
Individual 		Corporate Director
Board Member		 Aug 26, 2021
Jerrie Wise
Individual 		Corporate Director
Board Chair		 Jun 19, 1996
Kala M Smith
Individual 		Corporate Officer
Chief Dental Officer		 Jul 18, 2011
W-2 Managing Employee
Chief Dental Officer		 Jul 18, 2011
Joshua J Shackles
Individual 		Corporate Director
Board Vice Chair		 Aug 26, 2021
Elizabeth Persons
Individual 		Corporate Director
Board Treasurer		 Nov 19, 2009
John M Seidel
Individual 		Corporate Director
Board Member		 Feb 22, 2024
Charla J Miles
Individual 		Corporate Director
Board Member		 Aug 22, 2024
Charles H Bentlage
Individual 		Corporate Director
Board Member		 Jan 28, 2021
Allison Pruitt
Individual 		Corporate Director
Board Member		 Feb 22, 2024
Jeffrey Elmore
Individual 		Corporate Officer
Cio		 May 30, 2017
W-2 Managing Employee
Cio		 May 30, 2017
Joseph Zuzul
Individual 		Corporate Director
Board Member		 Jul 25, 2019
John D Paulson
Individual 		Corporate Officer
Chief Medical Officer		 Nov 27, 2023
W-2 Managing Employee
MD;		 Nov 27, 2023
Christian Demasi
Individual 		Corporate Director
Board Member		 Jul 25, 2014
Carrie E Foote
Individual 		Corporate Officer
Risk Compliance & Quality Director		 Oct 3, 2021
W-2 Managing Employee
Risk Compliance & Quality Director		 Oct 3, 2021
Rosario Keele
Individual 		Corporate Director
Board Member		 Feb 22, 2024
Donald McBride
Individual 		Corporate Officer
Ceo		 May 20, 2013
W-2 Managing Employee
Ceo		 May 20, 2013
Carmen K Brown
Individual 		Corporate Director
Board Member		 Mar 25, 2011

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130619000166 MO Part a Provider - Federally Qualified Health Center (FQHC) 8123918257 1 other NPI on this enrollment
Practice locations: Neosho, MO

National Provider Directory

Tax ID family
Ozark Tri-County Consortium (47 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

1120 Carl Sweeney Rd
Neosho, MO 64850-7743

Mailing address

PO Box 758
Neosho, MO 64850-0758
Phone (417) 451-9450

Other names

  • Access Family Care Doing business as

Other providers in Neosho, MO

All providers in Neosho, MO · Federally Qualified Health Center (FQHC) in Missouri

Sources for this page

Verify at the official NPI Registry.