NPIMap

Organization Active NPI

Preferred Family Healthcare, Inc.

Doing business as Clarity Healthcare

  • Federally Qualified Health Center (FQHC)
  • Hannibal, MO
National Provider Identifier
1689270852
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PREFERRED FAMILY HEALTHCARE, INC.
Doing business as
Clarity Healthcare
Practice address
3531 Stardust Dr
Hannibal, MO 63401-6224
Phone
(573) 603-1460
NPI assigned
Dec 11, 2020
Last updated
Jul 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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 1

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

Addresses

Primary practice location

3531 Stardust Dr
Hannibal, MO 63401-6224

Mailing address

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

Other practice location 1

3557 Stardust Dr
Hannibal, MO 63401-6224
Phone (573) 603-1460

Other names 1

  • Clarity Healthcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 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
This NPI is an additional NPI on the enrollment
Practice locations: Saint Louis, MO; Madison, MO; Saint Charles, MO; Paris, MO; Monroe City, MO; Moberly, MO; Montgomery City, MO; Saint Peters, MO…
O20210304000466 MO Part A Provider - Federally Qualified Health Center (FQHC) 0244256246 Practice locations: Hannibal, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689270852. Details of each certification follow.

Federally qualified health center certification: CCN 791008

Legal name
PREFERRED FAMILY HEALTHCARE INC
Doing business as
CLARITY HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 4, 2021
Last certification
Mar 4, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
3531 Stardust Dr
Hannibal, MO 63401-6224

Other NPIs on the same Medicare enrollment 16

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

View all 16

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2339158Clarity- Healthcare Stardust3531 Stardust Drive, Hannibal, MO 63401Certificate of waiverFeb 23, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Larry Shawn Sando Individual W-2 Managing EmployeeCeo Nov 1, 2025
Lisa Fairley Individual Corporate DirectorBoard Member Jun 29, 2004
Jennifer L Gagnon Individual Corporate OfficerAuthorized Representative Jan 1, 2022
Thomas Weber Individual Corporate OfficerAuthorized Representative Jan 2, 2015
Amanda R Carter Individual Corporate OfficerVice President, Managed Care Aug 1, 2024
Jim Bergman Individual Corporate DirectorBoard Member Sep 18, 2019
David Guth Individual Corporate OfficerAuthorized Representative Nov 1, 2025
Robert Berry Individual Corporate DirectorBoard Member Sep 21, 2011
Elphanie Swift Individual Corporate DirectorBoard Member Sep 18, 2019
Stanley Melton Individual Corporate DirectorBoard Member Dec 15, 2011
Anthony Henderson Individual Corporate DirectorBoard Member Mar 15, 2012
Carol Bean Individual Corporate OfficerAuthorized Representative Nov 1, 2025
John J Benson Individual Corporate DirectorBoard Member Feb 25, 1988
Carl D Davis Individual Corporate OfficerAuthorized Representative Jan 1, 2022
Sharon Brown Individual Corporate DirectorBoard Member Jan 15, 2003
Donald Crosby Individual Corporate DirectorBoard Member Jul 26, 2018

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1689270852",
    "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": "3531 STARDUST DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016224",
            "telephone_number": "573-603-1460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3557 Stardust Dr",
            "address_purpose": "LOCATION",
            "city": "Hannibal",
            "state": "MO",
            "postal_code": "634016224",
            "country_code": "US",
            "telephone_number": "573-603-1460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREFERRED FAMILY HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarity Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clarity Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.