Regional Health Care Clinic, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

REGIONAL HEALTH CARE CLINIC, INC

Practice address

500 S Keeney St
Cole Camp, MO 65325-1059

Phone

(660) 668-4427

Fax

(660) 827-8992

NPI assigned

Jul 26, 2019

Organization subpart

Yes

Parent organization

REGIONAL HEALTH CARE CLINIC, INCAs reported in NPPES

Name

Michael Waller

Title

Ceo

Phone

(660) 668-4427

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

• Regional Health Care Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Warsaw, MO
  • NPI 1053533539
  Same enrollment O20040304001212
• Regional Health Care Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Sedalia, MO
  • NPI 1922057504
  Same enrollment O20040304001212
• Regional Health Care Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Marshall, MO
  • NPI 1972981942
  Same enrollment O20040304001212
• Regional Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Green Ridge, MO
  • NPI 1417599556
  Same enrollment O20040304001212
• Regional Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sedalia, MO
  • NPI 1700532306
  Same enrollment O20040304001212

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katherine Anne Dumbell, DDS

  • General Practice Dentistry
  • Sedalia, MO
  • NPI 1316508732
  NPD
• Richard McKell Young, D.M.D

  • General Practice Dentistry
  • Sedalia, MO
  • NPI 1578507786
  NPD
• Bhavini Gopaldas, PA

  • Physician Assistant
  • Warsaw, MO
  • NPI 1811412372
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in MO

Part of

Community Free Clinic I

Locations

• Katy Trail Community Health Cole Camp R-1 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 21, 2024.

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1285288472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 WESTWOOD DR",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012102",
            "telephone_number": "660-826-4774",
            "fax_number": "660-827-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S KEENEY ST",
            "city": "COLE CAMP",
            "state": "MO",
            "postal_code": "653251059",
            "telephone_number": "660-668-4427",
            "fax_number": "660-827-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL HEALTH CARE CLINIC, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGIONAL HEALTH CARE CLINIC, INC",
        "enumeration_date": "2019-07-26",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "660-668-4427"
    },
    "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": "Katy Trail Community Health Cole Camp R-1",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Katy Trail Community Health Cole Camp R-1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pamela Sue Eckhoff, DNP, FNP-BC
• Good Samaritan Nursing Home
• Heart Core LLC
• Samantha Lang, MS, CCC-SLP
• Melissa Nienhuis, LAT, ATC
• Stephanie Danielle Schirding, MD
• Michael Scott Snell, R.PH
• Summers Pharmacy No 9, LLC Dba Summers Pharmacy of Cole Camp
• Misty Faye Todd, M.D.
• Amy Vandaveer, COTA

• All providers in Cole Camp, MO
• Federally Qualified Health Center (FQHC) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.