South Central Missouri Community Health Center
Organization Active NPI Federally Qualified Health Center (FQHC) · Salem, MO
NPI 1194615757 · NPPES record last updated Feb 11, 2026
Key facts
- NPI
- 1194615757
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER
- Practice address
- 703 South Grand Ave
Salem, MO 65560 - Phone
- (573) 426-4455
- NPI assigned
- Jul 7, 2025
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER
Authorized official
- Name
- Stuart Gipson
- Title
- Ceo
- Phone
- (573) 426-4455
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 12
Practitioners 12
-
Elaine Diane Briggs, DNP,APRN, FNP-BC
-
Dawn May Cavender-Erangey, APRN, FNP-BC
-
Hallie Caroline Davis, NURSE PRACTITIONER
-
Michaela Muehlbach, PSYD
-
Dawn Renee Tope, FNP
-
Alexis West, DNP
-
Margaret Ann Matlock, APRN-C
-
Mary K Zielke, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- South Central Missouri Community Health Center
- Part of
- South Central Missouri Community Health Center
Locations
1050 W 10th St
#480
Rolla, MO 65401
200 N Main St
Rolla, MO 65401
Phone (573) 458-6950
509 E 10th St
#Four
Rolla, MO 65401
200 N Main St
Ste G51
Rolla, MO 65401
Phone (573) 458-6010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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
- Four Rivers Community Health Center
Other providers in Salem, MO
- Jyotindra D. Shukla
- Amber Marie Simpson
- Bernard D Sirios
- Michelle Gray Sirois
- Crystal Denise Smith
- South Central Missouri Community Health Center
- South Central Missouri Community Health Center
- Emma Southards
- Yazhini Srivathsal
- St Johns Clinic Inc
All providers in Salem, MO · Federally Qualified Health Center (FQHC) in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2026. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.