NPIMap

Organization Active NPI

Preferred Family Healthcare, Inc

  • Community/Behavioral Health Agency
  • Kirksville, MO
National Provider Identifier
1649474206
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
6300-9238 Issued in MO
Legal business name
PREFERRED FAMILY HEALTHCARE, INC
Practice address
900 E Laharpe St
Kirksville, MO 63501-4520
Phone
(660) 665-1962
Fax
(660) 665-3989
NPI assigned
Jun 14, 2007
Last updated
Mar 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Authorized official

Name
Mark Conover
Title
Chief Revenue Officer
Phone
(573) 603-1460

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 6300-11443 MO
Community/Behavioral Health Agency 251S00000X 6300-9238 MO Primary

Addresses

Primary practice location

900 E Laharpe St
Kirksville, MO 63501-4520

Mailing address

1601 Old South River Rd
Saint Charles, MO 63303-4120
Phone (636) 224-1210

Other identifiers 1

IdentifierTypeStateIssuer
PARENT NPIOtherFOR BILLING ADDRESS ONLY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051019000599 MO Part B Supplier - Clinic/Group Practice 0244256246 Receives reassigned benefits from 143 practitioners
16 other NPIs on this enrollment
Practice locations: Saint Louis, MO; Madison, MO; Saint Charles, MO; Paris, MO; Monroe City, MO; Moberly, MO; Montgomery City, MO; Saint Peters, MO…
O20151124002928 IL Part B Supplier - Clinic/Group Practice 0244256246 Receives reassigned benefits from 15 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Quincy, IL; Pittsfield, IL

Other NPIs on the same Medicare enrollment 24

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

View all 24

National Provider Directory

National Provider Directory

Locations

1 Healthcare Pl
Bowling Green, MO 63334
Phone (573) 324-2111

11701 West Florissant Ave
Florissant, MO 63033
Phone (314) 972-8132

4355 Paris Gravel Rd
Hannibal, MO 63401
Phone (573) 248-3811

4600 McMasters Ave
Hannibal, MO 63401

1101 Jamison St
Kirksville, MO 63501
Phone (816) 665-1962

1570 S Main St
Saint Charles, MO 63303
Phone (636) 224-1000

1628 Oklahoma Ave
Trenton, MO 64683
Phone (660) 359-4600

1125 E Cherry St
Troy, MO 63379
Phone (636) 224-1500

Practitioners & affiliated clinicians

Practitioners 150

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 150

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1649474206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 OLD SOUTH RIVER RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633034120",
            "telephone_number": "636-224-1210",
            "fax_number": "636-246-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E LAHARPE ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014520",
            "telephone_number": "660-665-1962",
            "fax_number": "660-665-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED FAMILY HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "CONOVER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF REVENUE OFFICER",
        "authorized_official_telephone_number": "573-603-1460"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MO",
            "license": "6300-11443",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MO",
            "license": "6300-9238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FOR BILLING ADDRESS ONLY",
            "identifier": "PARENT NPI",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.