Ozark Tri-County Health Care Consortium

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

OZARK TRI-COUNTY HEALTH CARE CONSORTIUM

Doing business as

Access Family Care

Practice address

301 Big Spring Dr
Neosho, MO 64850-1700

Phone

(417) 782-6200

Fax

(417) 782-6210

NPI assigned

Feb 23, 2023

Last updated

Sep 15, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donald Michael McBride

Title

Ceo

Phone

(417) 451-9450

Specialties & licenses 1

Addresses

Other names 1

• Access Family Care Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1689373128. Details of each certification follow.

• CCN 261964 Federally qualified health center · Active · Details
• CCN 261949 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 261964

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

Dec 11, 2023

Last certification

Dec 11, 2023

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Enrollment address

301 Big Spring Dr
Neosho, MO 64850-1700

Federally qualified health center certification: CCN 261949

Legal name

ACCESS FAMILY CARE

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Oct 20, 2023

Last certification

Oct 20, 2023

Ownership / control type

For profit – corporation

Facility address

301 Big Spring Dr
Neosho, MO 64850

All disclosed owners & managing parties 21

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

Owners & managing parties with NPI records 3

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

• Charles Henry Bentlage, MD

  • Family Medicine Physician
  • Neosho, MO
  • NPI 1033436902

  Corporate Director

  CMS ownership
• John Derick Paulson, DO

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1801077797

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Kala Smith

  • Dentist
  • Joplin, MO
  • NPI 1558687871

  Corporate Officer, W-2 Managing Employee

  CMS ownership

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.

• Caleb K Boggs, PLPC

  • Professional Counselor
  • Joplin, MO
  • NPI 1750138079
  NPD (past)

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1689373128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 758",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648500758",
            "telephone_number": "417-451-9450",
            "fax_number": "417-451-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 BIG SPRING DR",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648501700",
            "telephone_number": "417-782-6200",
            "fax_number": "417-782-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARK TRI-COUNTY HEALTH CARE CONSORTIUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-451-9450"
    },
    "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": "Access Family Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Access Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)
• Ozark Tri-County Health Care Consortium (Access Family Care)

• Federally Qualified Health Center (FQHC) in Neosho, MO
• Providers in Neosho, 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 Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.