NPIMap

Organization Active NPI

Community Health Ctr of Central Missouri

  • Federally Qualified Health Center (FQHC)
  • Jefferson City, MO
National Provider Identifier
1790922920
Registry record updated Mar 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CTR OF CENTRAL MISSOURI
Practice address
1905 Stadium Blvd
Jefferson City, MO 65109-1961
Phone
(573) 632-2777
Fax
(573) 632-2769
NPI assigned
Jan 9, 2009
Last updated
Mar 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2016

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

Authorized official

Name
Toby Barnett
Title
Chief Fin Officer
Phone
(573) 632-0243

Specialties & licenses 1

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

Addresses

Primary practice location

1905 Stadium Blvd
Jefferson City, MO 65109-1961

Mailing address

PO Box 104780
Jefferson City, MO 65110-4780
Phone (573) 632-0243

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050610000717 MO Part B Supplier - Clinic/Group Practice 2062456015 Receives reassigned benefits from 31 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: California, MO; Fulton, MO; Jefferson City, MO; Linn, MO

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1790922920. Details of each certification follow.

  • CCN 261030 Federally qualified health center · Active · Name & address match · Details
  • CCN 261120 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 261030

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 16, 2009
Last certification
Mar 16, 2009
Ownership / control type
For profit – partnership
Facility address
1905 Stadium Blvd
Jefferson City, MO 65109

Federally qualified health center certification: CCN 261120

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COMMUNITY HLTH CTR OF CENTRAL MO COMPASS PEDIATRIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 3, 2016
Last certification
Jun 3, 2016
Ownership / control type
For profit – partnership
Facility address
1905 Stadium Blvd
Jefferson City, MO 65109

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

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": "1231459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457568000000",
    "number": "1790922920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 104780",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651104780",
            "telephone_number": "573-632-0243",
            "fax_number": "573-632-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 STADIUM BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651091961",
            "telephone_number": "573-632-2777",
            "fax_number": "573-632-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CTR OF CENTRAL MISSOURI",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-09",
        "last_updated": "2016-03-10",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "TOBY",
        "authorized_official_title_or_position": "CHIEF FIN OFFICER",
        "authorized_official_telephone_number": "573-632-0243"
    },
    "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 Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.