Crider Health Center,Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

CRIDER HEALTH CENTER,INC

Practice address

1032 Crosswinds CT
Wentzville, MO 63385-4836

Phone

(636) 332-6000

Fax

(363) 332-3045

NPI assigned

Nov 25, 2009

Organization subpart

No

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

Authorized official

Name

Laura Heebner

Title

Associate Ceo, Coo

Phone

(636) 332-8306

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Crider Center for Menta2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Crider Health Center, Inc.

  • Multi-Specialty Clinic/Center
  • Wentzville, MO
  • NPI 1467762229
  NPD tax ID

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320364800000",
    "number": "1366770604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 CROSSWINDS CT",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633854836",
            "telephone_number": "636-332-6000",
            "fax_number": "363-332-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 CROSSWINDS CT",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633854836",
            "telephone_number": "636-332-6000",
            "fax_number": "363-332-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRIDER HEALTH CENTER,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-25",
        "last_updated": "2011-11-04",
        "status": "A",
        "authorized_official_last_name": "HEEBNER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "ASSOCIATE CEO, COO",
        "authorized_official_telephone_number": "636-332-8306"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "504605312",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Nicole Covington, RDH
• Sydney Frances Cowan, COTA/L
• CR Chiropractic, LLC
• Christina Marrie Craven, AGNP-C
• Crider Health Center, Inc.
• Andrea L Crislip
• Pamela Elaine Crismon, LPC
• Farrah Lanett Crockett
• Courtney Croghan
• James Cuellar, MD

• Federally Qualified Health Center (FQHC) in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Federally Qualified Health Center (FQHC) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.