Preferred Family Healthcare, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Quincy, IL
NPI 1124499074 · NPPES record last updated Jun 10, 2022
Key facts
- NPI
- 1124499074
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- PREFERRED FAMILY HEALTHCARE, INC.
- Practice address
- 540 Harrison St
Quincy, IL 62301-7236 - Phone
- (573) 603-1460
- Fax
- (573) 603-1462
- NPI assigned
- Oct 16, 2015
- Organization subpart
- No
Authorized official
- Name
- Mark Conover
- Title
- Chief Revenue Officer
- Phone
- (660) 665-1962
Other NPIs on the same Medicare enrollment 8
Corporate family (same tax ID) 10
Practitioners 3
-
Tonya Stamper, CNP
-
Chanda L Herron, LCSW
-
John T. Sylvara, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL
Federally qualified health center certification: CCN 781843
- Legal name
- PREFERRED FAMILY HEALTHCARE INC
- Doing business as
- CLARITY HEALTHCARE
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Nov 9, 2015
- Last certification
- Nov 9, 2015
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 20, 2007 in MO
- Enrollment address
- 540 Harrison St
Quincy, IL 62301-7236
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Larry Shawn Sando |
W-2 Managing Employee |
Nov 1, 2025 | |
| Lisa Fairley |
Corporate Director |
Jun 29, 2004 | |
| Jennifer L Gagnon |
Corporate Officer |
Jan 1, 2022 | |
| Thomas Weber |
Corporate Officer |
Jan 2, 2015 | |
| Amanda R Carter |
Corporate Officer |
Jan 22, 2018 | |
| Jim Bergman |
Corporate Director |
Sep 18, 2019 | |
| David Guth |
Corporate Officer |
Nov 1, 2025 | |
| Robert Berry |
Corporate Director |
Sep 21, 2011 | |
| Elphanie Swift |
Corporate Director |
Sep 18, 2019 | |
| Stanley Melton |
Corporate Director |
Dec 15, 2011 | |
| Anthony Henderson |
Corporate Director |
Mar 15, 2015 | |
| Carol Bean |
Corporate Officer |
Nov 1, 2025 | |
| John J Benson |
Corporate Director |
Feb 25, 1988 | |
| Carl D Davis |
Corporate Officer |
Jan 1, 2022 | |
| Sharon Brown |
Corporate Director |
Jan 15, 2003 | |
| Donald Crosby |
Corporate Director |
Jul 26, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151105002841 | IL | Part a Provider - Federally Qualified Health Center (FQHC) | 0244256246 | Practice locations: Quincy, IL |
| O20151124002928 | IL | Part B Supplier - Clinic/Group Practice | 0244256246 |
Receives reassigned benefits from 15 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Quincy, IL; Pittsfield, IL |
National Provider Directory
- Tax ID family
- Preferred Family Health Care Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Dental Clinic/Center | 261QD0000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes | ||
| Primary Care Clinic/Center | 261QP2300X |
Addresses
Primary practice location
540 Harrison St
Quincy, IL 62301-7236
Mailing address
1601 Old South River Rd
Saint Charles, MO 63303-4120
Other names
- Clarity Healthcare
Other providers in Quincy, IL
- Ellen L. Pratt
- Katherine S Pray
- Preferred Family Healthcare Inc
- Preferred Family Healthcare, Inc.
- Preferred Family Healthcare, Inc.
- Preferred Family Healthcare, Inc.
- Preferred Family Healthcare, Inc.
- Preferred Family Healthcare, Inc.
- Preferred Family Healthcare, Inc.
- Preferred Family Healthcare, Inc.
All providers in Quincy, IL · Federally Qualified Health Center (FQHC) in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.