NPIMap

Organization Active NPI

Rural Alliance for Better Family Health

Doing business as Southern Missouri Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Thayer, MO
National Provider Identifier
1245874510
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RURAL ALLIANCE FOR BETTER FAMILY HEALTH
Doing business as
Southern Missouri Community Health Center
Practice address
401 E Walnut St
Thayer, MO 65791-1533
Phone
(417) 255-8464
Fax
(417) 255-9732
NPI assigned
Oct 30, 2019
Last updated
Feb 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
Bryan Adcock
Title
Ceo
Phone
(417) 255-8464

Specialties & licenses 1

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

Addresses

Primary practice location

401 E Walnut St
Thayer, MO 65791-1533

Mailing address

1137 Independence Dr
West Plains, MO 65775-4221
Phone (417) 255-8464

Other names 1

  • Southern Missouri Community Health Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smchc@myezyaccess.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040316001026 MO Part B Supplier - Clinic/Group Practice 6103734058 Receives reassigned benefits from 12 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Thayer, MO; West Plains, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245874510. Details of each certification follow.

  • CCN 261197 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 261197

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SOUTHERN MISSOURI COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 2, 2020
Last certification
Apr 2, 2020
Ownership / control type
For profit – corporation
Facility address
401 East Walnut Street
Thayer, MO 65791

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1245874510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 INDEPENDENCE DR",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657754221",
            "telephone_number": "417-255-8464",
            "fax_number": "417-255-9732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E WALNUT ST",
            "city": "THAYER",
            "state": "MO",
            "postal_code": "657911533",
            "telephone_number": "417-255-8464",
            "fax_number": "417-255-9732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL ALLIANCE FOR BETTER FAMILY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-30",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "ADCOCK",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-255-8464"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smchc@myezyaccess.com",
            "affiliation": "N",
            "endpointDescription": "Secure direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Free Text",
            "address_1": "1137 Independence Dr",
            "city": "West Plains",
            "state": "MO",
            "country_code": "US",
            "postal_code": "657754221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Southern Missouri Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Missouri Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thayer, MO

Sources for this page

Verify at the official NPI Registry.