NPIMap

Organization Active NPI

Preferred Family Healthcare, Inc

  • Federally Qualified Health Center (FQHC)
  • Columbia, MO
National Provider Identifier
1750160578
Registry record updated Sep 22, 2023
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
Practice address
1010 Range Line St
Columbia, MO 65201-4565
Phone
(573) 476-0030
Fax
(573) 442-5200
NPI assigned
Sep 22, 2023
Organization subpart
No

Authorized official

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

Practitioners 2

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240111001849 MO Part a Provider - Federally Qualified Health Center (FQHC) 0244256246 Practice locations: Columbia, MO

Federally qualified health center certification: CCN 261969

Medicare enrollment files
Legal name
PREFERRED FAMILY HEALTHCARE INC
Doing business as
CLARITY HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 11, 2024
Last certification
Jan 11, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1010 Range Line St
Columbia, MO 65201-4565

All disclosed owners & managing parties 16

Medicare enrollment files

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, Centerstone Medical Group Nov 1, 2025
Lisa Fairley Individual Corporate DirectorBoard Member Jun 29, 2004
Jennifer L Gagnon Individual Corporate OfficerCfo Jan 1, 2022
Thomas Weber Individual Corporate OfficerDivision President, West Jan 2, 2015
Amanda R Carter Individual Corporate OfficerVice President, Managed Care Jan 22, 2018
Jim Bergman Individual Corporate DirectorBoard Member Sep 18, 2019
David Guth Individual Corporate OfficerCeo 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 OfficerDivision President, East Nov 1, 2025
John J Benson Individual Corporate DirectorBoard Member Feb 25, 1988
Carl D Davis Individual Corporate OfficerCeo Elect Jan 1, 2022
Sharon Brown Individual Corporate DirectorBoard Member Jan 15, 2003
Donald Crosby Individual Corporate DirectorBoard Member Jul 26, 2018

National Provider Directory

National Provider Directory
Tax ID family
Preferred Family Health Care Inc149 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

141 Communication Dr
Hannibal, MO 63401
Phone (573) 795-7342

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

1010 Range Line St
Columbia, MO 65201-4565

Mailing address

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

Other names 1

NPPES NPI Registry
  • Clarity Healthcare Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 22, 2023.

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695340800000",
    "number": "1750160578",
    "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": "1010 RANGE LINE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652014565",
            "telephone_number": "573-476-0030",
            "fax_number": "573-442-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED FAMILY HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-21",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarity Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.