Douglas County Public Health Services Group, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Gainesville, MO
NPI 1851590509 · NPPES record last updated Jul 13, 2007
Key facts
- NPI
- 1851590509
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- License
- 2007018212 (MO)
- Legal business name
- DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.
- Practice address
- 201 S. Elm Street
Gainesville, MO 65655 - Phone
- (417) 679-2775
- Fax
- (417) 679-2633
- NPI assigned
- Jul 13, 2007
- Organization subpart
- No
Authorized official
- Name
- Richard R Sims
- Title
- Ceo
- Phone
- (417) 683-4831
Other NPIs on the same Medicare enrollment 9
Practitioners 2
-
Donna F Harper, DO
-
Marti Lea Warden, APN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050301000128 | MO | Part B Supplier - Clinic/Group Practice | 3072423052 |
Receives reassigned benefits from 33 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Ava, MO; Theodosia, MO; Mountain Grove, MO; Mansfield, MO; Licking, MO; Houston, MO; Gainesville, MO; Cabool, MO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | 2007018212 | MO | Yes |
Addresses
Primary practice location
201 S. Elm Street
Gainesville, MO 65655
Mailing address
PO Box 216
Gainesville, MO 65655-0216
Phone (417) 679-2775
Other names
- Missouri Ozarks Community Health
Other providers in Gainesville, MO
- Chris V Geroff DDS PC
- Clear View Consulting and Behavioral Health
- Community Care Center of Gainesville, Inc
- Tamara Dees
- Douglas County Public Health Services Group, Inc.
- Callie Coppedge Emmart
- Firstcall Family Healthcare
- Gainesville Pharmacy LLC
- Gainesville R-V School District
- Chris V Geroff
All providers in Gainesville, MO · Federally Qualified Health Center (FQHC) in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.