Western Missouri Medical Center
Organization Active NPI Rural Health Clinic/Center · Concordia, MO
NPI 1215388293 · NPPES record last updated Nov 1, 2021
Key facts
- NPI
- 1215388293
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- WESTERN MISSOURI MEDICAL CENTER
- Practice address
- 905 S Main St
Concordia, MO 64020 - Phone
- (660) 463-7966
- Fax
- (660) 463-7729
- NPI assigned
- Jun 30, 2016
- Organization subpart
- No
Authorized official
- Name
- Michael Dean Ohmart
- Title
- Cfo
- Phone
- (660) 262-7307
Owners & managing parties with NPI records 2
-
Lawrence William Purcell, D.D.S.
Other NPIs on the same Medicare enrollment 18
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 2
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 4
Practitioners 37
-
Jill Cobb, FNP-C
-
Dawn Marie Diamond, FNP-C
-
Sara Ann Howe, MD
-
Sarah Nicole Krause, APRN
-
Jessica McMillan, FNP-C
-
Wren Moss, FNP-C
-
Brandon Abbott, D.O.
-
Ashley L Alumbaugh, M.D.
-
Muhammad Asif, M.D.
-
Jeanne Lynn Birchmier, D.O.
-
Kendra F Butner, MSN BC FNP
-
Debbie L. Freels, RN, MSN, FNP-BC, CNM
-
Drew Washington Glover, M.D.
-
Deborah L Gregory, D.O.
-
Brent Kevin Hoke, DO
-
Suzanne Elizabeth Pierce, FNP-BC
-
David V Pulliam, D.O.
-
Rebecca Anne Seelinger, MSN, ARNP, FNP-C
-
Jillian Colleen Simmons, DNP, APRN, CNM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MO
Rural health clinic certification: CCN 268775
- Legal name
- WESTERN MISSOURI MEDICAL CENTER
- Doing business as
- WESTERN MO FAMILY HEALTHCARE - CONCORDIA
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Dec 18, 2019
- Last certification
- Dec 18, 2019
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Enrollment address
- 905 S Main St
Concordia, MO 64020-8335 - Related CCNs
- 260097
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Rita White |
Corporate Director |
Aug 1, 2019 | |
| Larry W Purcell |
Corporate Director |
Aug 1, 2019 | |
| Amanda Broderson |
W-2 Managing Employee |
Jan 1, 2026 | |
| Lacey D Bredehoeft-Fiene |
Corporate Officer |
Jan 15, 2026 | |
| Darinda J Dick |
Corporate Officer |
Aug 1, 2019 | |
| Corporate Director |
Aug 1, 2019 | ||
| W-2 Managing Employee |
Aug 1, 2019 | ||
| Western Missouri Medical Center |
5% Or Greater Direct Ownership Interest | Aug 1, 2019 | 100% |
| Greg Hassler |
Corporate Director |
Aug 1, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040616000777 | MO | Part B Supplier - Clinic/Group Practice | 7416931506 |
Receives reassigned benefits from 138 practitioners 23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Warrensburg, MO |
| O20091022000298 | MO | Part B Supplier - Clinic/Group Practice | 5092852111 |
Receives reassigned benefits from 35 practitioners 2 other NPIs on this enrollment Practice locations: Concordia, MO; Warrensburg, MO; Knob Noster, MO |
| O20190802000308 | MO | Part a Provider - Rural Health Clinic | 5092852111 | Practice locations: Concordia, MO |
National Provider Directory
- Tax ID family
- Western Missouri Family Express Care
Locations
600 E Allen St
Knob Noster, MO 65336
Phone (660) 563-5555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
905 S Main St
Concordia, MO 64020
Mailing address
905 S Main St
Concordia, MO 64020-8335
Phone (660) 463-7966
Other names
- Western Missouri Family Healthcare - Concordia
Other providers in Concordia, MO
- Douglas D Smith
- Morgan Toensing
- Jami Vandevort
- Warrensburg Optical Inc
- Waterfall Chiropractic LLC
- Western Missouri Medical Center
- Western Missouri Nursing and Rehab LLC
- Fawn Zimmer
All providers in Concordia, MO · Rural Health Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2021. 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.