Ozark Tri-County Healthcare Consortium

Organization Active NPI Federally Qualified Health Center (FQHC) · Goodman, MO

NPI 1558712422 · NPPES record last updated Apr 14, 2026

Key facts

NPI
1558712422
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
OZARK TRI-COUNTY HEALTHCARE CONSORTIUM
Practice address
117 N School St
Goodman, MO 64843-9723
Phone
(417) 782-6200
Fax
(417) 782-6210
NPI assigned
Jun 22, 2016
Organization subpart
No

Authorized official

Name
Don M McBride
Title
Ceo
Phone
(417) 451-9450

Owners & managing parties with NPI records 3

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

Corporate family (same tax ID) 46

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

View all 46

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Federally qualified health center certification: CCN 261947

Legal name
OZARK TRI-COUNTY HEALTH CARE CONSORTIUM
Doing business as
ACCESS FAMILY CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 29, 2023
Last certification
Sep 29, 2023
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Jun 19, 1996 in MO
Enrollment address
117 N School St
Goodman, MO 64843-9723

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Julia M Leibbrand
Individual
W-2 Managing Employee Aug 26, 2013
Robin a Chapman
Individual
Corporate Director
Board Member
Feb 23, 2023
Sheila R Long
Individual
Corporate Officer
Chief Financial Officer
May 14, 2007
W-2 Managing Employee May 14, 2007
Keenan T Cortez
Individual
Corporate Director
Board Member
Aug 26, 2021
Jerrie Wise
Individual
Corporate Director
Board Chair
Jun 15, 1996
Kala M Smith
Individual
Corporate Officer
Chief Dental Officer
Jul 18, 2011
W-2 Managing Employee
Chief Dental Officer
Jul 18, 2011
Joshua J Shackles
Individual
Corporate Director
Board Member
Aug 26, 2021
Elizabeth Persons
Individual
Corporate Director
Board Secretary
Nov 19, 2009
Charles H Bentlage
Individual
Corporate Director
Board Vice Chair
Jan 28, 2021
Tracy a Godfrey
Individual
Corporate Officer
Chief Medical Officer
Nov 1, 2021
W-2 Managing Employee
Chief Medical Officer
Nov 1, 2021
Jessica G Cullers
Individual
Corporate Director
Board Treasurer
Dec 16, 2021
Jeffrey Elmore
Individual
Corporate Officer
Chief Information Officer
May 30, 2017
W-2 Managing Employee
Chief Information Officer
May 30, 2017
Hillary Shadwick
Individual
Corporate Officer
Chief Human Resource Officer
Sep 24, 2018
W-2 Managing Employee
Chief Human Resource Officer
Sep 24, 2018
Joseph Zuzul
Individual
Corporate Director
Board Member
Jul 25, 2019
Christian Demasi
Individual
Corporate Director Jul 25, 2014
Donald McBride
Individual
Corporate Officer
Chief Executive Officer
Feb 27, 2006
W-2 Managing Employee Feb 27, 2006
Carmen K Brown
Individual
Corporate Director
Board Member
Mar 25, 2011
Cynthia McCoy
Individual
Corporate Director
Board Member
Jan 25, 2018

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20161103001643 MO Part a Provider - Federally Qualified Health Center (FQHC) 8123918257 Practice locations: Goodman, MO

National Provider Directory

Tax ID family
Ozark Tri-County Consortium (47 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

117 N School St
Goodman, MO 64843-9723

Mailing address

PO Box 758
Neosho, MO 64850-0758
Phone (417) 451-9450

Other names

  • Access Family Care Doing business as

Other providers in Goodman, MO

All providers in Goodman, MO · Federally Qualified Health Center (FQHC) in Missouri

Sources for this page

Verify at the official NPI Registry.