Preferred Family Healthcare, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Quincy, IL
NPI 1871969964 · NPPES record last updated Jul 29, 2022
Key facts
- NPI
- 1871969964
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- PREFERRED FAMILY HEALTHCARE, INC.
- Practice address
- 639 York St RM 212
Quincy, IL 62301-3919 - Phone
- (660) 665-1962
- NPI assigned
- Aug 12, 2015
- Organization subpart
- No
Authorized official
- Name
- Mark Conover
- Title
- Chief Revenue Officer
- Phone
- (660) 665-1962
Owners & managing parties with NPI records 1
-
Garima Singh, MD
Other NPIs on the same Medicare enrollment 8
Corporate family (same tax ID) 10
Practitioners 5
-
Dallas Cressell, LCPC
-
Jessica N Baker, MS, LPC
-
Pamela Barrigar, MSW, LCSW
-
Matthew K Wells, DNP, FPMHNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI, IL
Federally qualified health center certification: CCN 781839
- Legal name
- PREFERRED FAMILY HEALTHCARE INC
- Doing business as
- CLARITY HEALTHCARE
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Nov 12, 2015
- Last certification
- Nov 12, 2015
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 27, 2007 in MO
- Enrollment address
- 639 York St
RM 212
Quincy, IL 62301-3919
All disclosed owners & managing parties 19
| Name | Role | Since | Share |
|---|---|---|---|
| Lisa Fairley |
Corporate Director |
Jun 29, 2004 | |
| Jennifer L Gagnon |
Corporate Officer |
Jan 1, 2022 | |
| Thomas Weber |
Corporate Officer |
Jan 2, 2015 | |
| Amanda R Carter |
W-2 Managing Employee |
Aug 1, 2024 | |
| Mendie Schoeller |
Corporate Officer |
Dec 16, 2013 | |
| Jim Bergman |
Corporate Director |
Sep 18, 2019 | |
| Robert Berry |
Corporate Director |
Sep 21, 2011 | |
| Michael Schwend |
Corporate Officer |
Jul 14, 1984 | |
| W-2 Managing Employee |
Aug 24, 2015 | ||
| Elphanie Swift |
Corporate Director |
Sep 18, 2019 | |
| Garima Singh |
Corporate Officer |
Jan 1, 2022 | |
| Stanley Melton |
Corporate Director |
Dec 15, 2011 | |
| Anthony Henderson |
Corporate Director |
Mar 15, 2012 | |
| Mark a Conover |
Corporate Officer |
Oct 5, 2018 | |
| W-2 Managing Employee |
Oct 5, 2018 | ||
| John J Benson |
Corporate Director |
Feb 25, 1988 | |
| Carl D Davis |
Corporate Officer |
Jan 1, 2022 | |
| Sharon Brown |
Corporate Director |
Jan 15, 2003 | |
| Andrew Thomas Schwend |
Corporate Officer |
Dec 1, 2014 | |
| Stacey Hudson |
Corporate Officer |
Oct 15, 2018 | |
| Donald Crosby |
Corporate Director |
Jul 26, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151019000228 | WI | Part a Provider - Federally Qualified Health Center (FQHC) | 0244256246 | Practice locations: Quincy, IL |
| O20151124002928 | IL | Part B Supplier - Clinic/Group Practice | 0244256246 |
Receives reassigned benefits from 15 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Quincy, IL; Pittsfield, IL |
National Provider Directory
- Tax ID family
- Preferred Family Health Care Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Dental Clinic/Center | 261QD0000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes | ||
| Primary Care Clinic/Center | 261QP2300X |
Addresses
Primary practice location
639 York St RM 212
Quincy, IL 62301-3919
Mailing address
1601 Old South River Rd
Saint Charles, MO 63303-4120
Phone (636) 224-1210
Other names
- Clarity Healthcare
Other providers in Quincy, IL
- Preferred Family Healthcare, Inc.
- Preferred Family Healthcare, Inc.
- Preferred Family Healthcare, Inc.
- Preferred Family Healthcare, Inc.
- Preferred Family Healthcare, Inc.
- Preferred Family Healthcare, Inc.
- Rachel L Prewitt
- Kourtney Price
- Primary Care Physicians, S.C.
- Jennifer Suzanne Pritts
All providers in Quincy, IL · Federally Qualified Health Center (FQHC) in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2022. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.