Active NPI
AIDS Project of the Ozarks
- Nurse Practitioner
- Springfield, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- AIDS PROJECT OF THE OZARKS
- Practice address
- 1636 So. Glenstone, Ste. 100
Springfield, MO 65804-6580 - Phone
- (417) 881-1300
- Fax
- (417) 881-1237
- NPI assigned
- Aug 17, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amber Cornelison
- Title
- Office Manager
- Phone
- (417) 881-1900
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Nurse Practitioner | 363L00000X | Primary |
Addresses
Primary practice location
1636 So. Glenstone, Ste. 100
Springfield, MO 65804-6580
Mailing address
1636 So. Glenstone, Ste. 100
Springfield, MO 65804-1434
Phone (417) 881-1300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600045091 | Medicaid | MO |
Other names 1
- APO
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080922000178 | MO | Part B Supplier - Clinic/Group Practice | 4981771730 |
Receives reassigned benefits from 9 practitioners Practice locations: Springfield, MO |
| O20230228001401 | MO | Part A Provider - Federally Qualified Health Center (FQHC) | 4981771730 | Practice locations: Springfield, MO |
Federally qualified health center certification: CCN 261923
- Legal name
- AIDS PROJECT OF THE OZARKS
- Doing business as
- APO
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Feb 27, 2023
- Last certification
- Feb 27, 2023
- Ownership / control type
- For profit – corporation
- Organization structure
- Other
- Incorporated
- Oct 30, 1985 in MO
- Enrollment address
- 1636 S Glenstone Ave
Ste 100
Springfield, MO 65804-1527
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider DirectoryLocations
303 Park Central W
Springfield, MO 65806
Phone (417) 881-1900
Ownership & related parties
All disclosed owners & managing parties 15
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Teressa Crane-Brown | Corporate Officer | Aug 1, 2008 | |
| Corporate Director | Aug 1, 2008 | ||
| Chris Rees | Corporate Officer | Aug 1, 2008 | |
| Corporate Director | Aug 1, 2008 | ||
| Jonathan Johnson | Corporate Officer | Aug 1, 2008 | |
| Corporate Director | Aug 1, 2008 | ||
| Jeffery Tumlin | Corporate Officer | Aug 1, 2008 | |
| Corporate Director | Aug 1, 2008 | ||
| Joy Fountain | Corporate Officer | Aug 1, 2008 | |
| Corporate Director | Aug 1, 2008 | ||
| Tom Vandeberg | Corporate Officer | Aug 1, 2008 | |
| Corporate Director | Aug 1, 2008 | ||
| Bradley M Haller | Corporate Officer | Feb 1, 2014 | |
| Corporate Director | Feb 1, 2014 | ||
| Michelle Winslow | Corporate Officer | Aug 1, 2008 | |
| Corporate Director | Aug 1, 2008 | ||
| Shelly J Farnan-Moore | Corporate Officer | Aug 1, 2008 | |
| Corporate Director | Aug 1, 2008 | ||
| Lynne Meyerkord | Corporate Officer | Jan 1, 2014 | |
| Corporate Director | Jan 1, 2014 | ||
| W-2 Managing Employee | Aug 1, 2008 | ||
| Clarissa French | Corporate Officer | Aug 1, 2008 | |
| Corporate Director | Aug 1, 2008 | ||
| Jane Pike | Corporate Officer | Aug 1, 2008 | |
| Corporate Director | Aug 1, 2008 | ||
| Rose Degray | Corporate Officer | Sep 18, 2013 | |
| Corporate Director | Sep 18, 2013 | ||
| Kris Barefield | Corporate Officer | Aug 1, 2008 | |
| Corporate Director | Aug 1, 2008 | ||
| Emily Bowen | Corporate Officer | Aug 1, 2008 | |
| Corporate Director | Aug 1, 2008 |
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Springfield, MO
- NPI 1821870437
MO
-
- Mental Health Counselor
- Springfield, MO
- NPI 1750056115
Mental Health, MO
-
- Mental Health Counselor
- Rogersville, MO
- NPI 1134558422
Mental Health, MO
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187308800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1770249600000",
"number": "1366634859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1636 SO. GLENSTONE, STE. 100",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658041434",
"telephone_number": "417-881-1300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1636 SO. GLENSTONE, STE. 100",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658046580",
"telephone_number": "417-881-1300",
"fax_number": "417-881-1237"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AIDS PROJECT OF THE OZARKS",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-17",
"last_updated": "2026-02-05",
"certification_date": "2026-02-05",
"status": "A",
"authorized_official_last_name": "CORNELISON",
"authorized_official_first_name": "AMBER",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "417-881-1900"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "600045091",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "APO",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "APO",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.