NPIMap

Organization Active NPI

A T Still University of Health Sciences

  • Rural Health Clinic/Center
  • Kirksville, MO
National Provider Identifier
1245051895
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
A T STILL UNIVERSITY OF HEALTH SCIENCES
Doing business as
A T Still University of Health Sciences
Practice address
800 W Jefferson St
Kirksville, MO 63501-1443
Phone
(660) 626-2222
Fax
(660) 626-2150
NPI assigned
Oct 17, 2024
Last updated
Feb 11, 2026By the provider in NPPES
Organization subpart
No

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
Adam M Moore
Title
Executive Director of Practice
Phone
(660) 626-2739

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

800 W Jefferson St
Kirksville, MO 63501-1443

Mailing address

800 W Jefferson St
Kirksville, MO 63501-1443
Phone (660) 626-2222

Other names 1

  • A T Still University of Health Sciences Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241125000732 MO Part A Provider - Rural Health Clinic 3971404120 Practice locations: Kirksville, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245051895. Details of each certification follow.

Rural health clinic certification: CCN 793870

Legal name
A T STILL UNIVERSITY OF HEALTH SCIENCES
Organization structure
CorporationNon-profit
Enrollment address
800 W Jefferson St
Kirksville, MO 63501-1443

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
A T Still University Health Science5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

210A S Osteopathy Ave
Kirksville, MO 63501
Phone (660) 626-2717

2206 S Halliburton St
Kirksville, MO 63501
Phone (660) 627-7416

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Linnette J Sells Individual Corporate OfficerBoard Member Oct 28, 2016
Danielle L Barnett-Trapp Individual Corporate OfficerBoard Member Oct 8, 2021
Craig M Phelps Individual Corporate DirectorChancellor Jul 1, 2012
W-2 Managing EmployeeChancellor Jul 1, 2012
Renee Clark Individual Corporate OfficerBoard Member Oct 18, 2024
Kimberly G Perry Individual Corporate OfficerBoard Member Oct 14, 2022
Dana Funderburk Individual Corporate DirectorCfo Jul 1, 2021
W-2 Managing EmployeeCfo Jul 1, 2021
Linda Eremita Individual Corporate OfficerBoard Member Oct 8, 2021
Reid W Butler Individual Corporate OfficerBoard Member Sep 30, 2011
Marco Clark Individual Corporate OfficerBoard Member Oct 8, 2021
Felix M Valbuena Individual Corporate OfficerBoard Member Oct 14, 2022
Adam Moore Individual W-2 Managing EmployeeAd; Oct 1, 2024
Herb B. Kuhn Individual Corporate OfficerBoard Member Oct 26, 2018
Allan Morgan Individual Corporate DirectorBoard Member Oct 2, 2020
Jonathan L Cleaver Individual Corporate OfficerBoard Member Oct 11, 2019
Michelle L. Mayo Individual Corporate OfficerBoard Member Oct 28, 2016
Floyd Simpson Individual Corporate OfficerBoard Member Oct 8, 2021
Isaac Robert Navarro Individual Corporate OfficerBoard Member Oct 11, 2019
Michael Torgan Individual Corporate OfficerBoard Member Oct 13, 2023
John Richard Thurman Individual Corporate OfficerBoard Member Oct 13, 2023

Owners & managing parties with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770768000000",
    "number": "1245051895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W JEFFERSON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635011443",
            "telephone_number": "660-626-2222",
            "fax_number": "660-626-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W JEFFERSON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635011443",
            "telephone_number": "660-626-2222",
            "fax_number": "660-626-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A T STILL UNIVERSITY OF HEALTH SCIENCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-17",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF PRACTICE",
        "authorized_official_telephone_number": "660-626-2739"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A T Still University of Health Sciences",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kirksville, MO

Sources for this page

Verify at the official NPI Registry.