NPIMap

Organization Active NPI

South Central Missouri Community Health Center

Doing business as Four Rivers Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Salem, MO
National Provider Identifier
1194615757
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER
Doing business as
Four Rivers Community Health Center
Practice address
703 South Grand Ave
Salem, MO 65560
Phone
(573) 426-4455
NPI assigned
Jul 7, 2025
Last updated
Feb 11, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Authorized official

Name
Stuart Gipson
Title
Ceo
Phone
(573) 426-4455

Specialties & licenses 1

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

Addresses

Primary practice location

703 South Grand Ave
Salem, MO 65560

Mailing address

1081 E 18TH St
Rolla, MO 65401-3398
Phone (573) 426-4455

Other names 1

  • Four Rivers Community Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111013000097 MO Part B Supplier - Clinic/Group Practice 1355513581 Receives reassigned benefits from 27 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rolla, MO; Cuba, MO; Salem, MO; Saint Robert, MO

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
South Central Mo Center13 organizations share this tax ID, including this one
Part of
South Central Mo Center

Other organizations with this tax ID 12

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

Locations

1050 W 10th St
#480
Rolla, MO 65401

1050 W 10th St
Ste 480
Rolla, MO 65401
Phone (573) 364-1900

200 N Main St
Ste G51
Rolla, MO 65401
Phone (573) 458-6010

509 E 10th St
Rolla, MO 65401
Phone (573) 364-7777

509 E 10th St
#Four
Rolla, MO 65401

165 Park Dr
Saint Robert, MO 65584
Phone (573) 433-3559

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770768000000",
    "number": "1194615757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 E 18TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013398",
            "telephone_number": "573-426-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 SOUTH GRAND AVE",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "65560",
            "telephone_number": "573-426-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER",
        "enumeration_date": "2025-07-07",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A",
        "authorized_official_last_name": "GIPSON",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-426-4455"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four Rivers Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; 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.