NPIMap

Organization Active NPI

Douglas County Public Health Services Group, Inc.

  • Federally Qualified Health Center (FQHC)
  • Theodosia, MO
National Provider Identifier
1588511133
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.
Practice address
4900 State Hwy 160
Theodosia, MO 65761
Phone
(417) 683-5739
NPI assigned
Mar 12, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Authorized official

Name
Jennifer Heinlein
Title
Coo
Phone
(417) 683-5739

Specialties & licenses 1

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

Addresses

Primary practice location

4900 State Hwy 160
Theodosia, MO 65761

Mailing address

PO Box 1359
Ava, MO 65608-1359
Phone (417) 683-5739

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050301000128 MO Part B Supplier - Clinic/Group Practice 3072423052 Receives reassigned benefits from 33 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ava, MO; Theodosia, MO; Mountain Grove, MO; Mansfield, MO; Licking, MO; Houston, MO; Gainesville, MO; Cabool, MO

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Douglas County Public Health Services Group Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1773273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773273600000",
    "number": "1588511133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1359",
            "city": "AVA",
            "state": "MO",
            "postal_code": "656081359",
            "telephone_number": "417-683-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 STATE HWY 160",
            "city": "THEODOSIA",
            "state": "MO",
            "postal_code": "65761",
            "telephone_number": "417-683-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-12",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "HEINLEIN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "417-683-5739"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Theodosia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.