NPIMap

Ozark Tri-County Health Care Consortium

Organization Active NPI Federally Qualified Health Center (FQHC) · Lamar, MO

NPI 1891452835 · NPPES record last updated Sep 9, 2024

Key facts

NPI
1891452835
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
OZARK TRI-COUNTY HEALTH CARE CONSORTIUM
Practice address
805 Broadway St
Lamar, MO 64759-1224
Phone
(417) 262-6070
Fax
(417) 262-6071
NPI assigned
Nov 24, 2021
Organization subpart
No

Authorized official

Name
Donald M McBride
Title
Ceo
Phone
(417) 451-9450

Owners & managing parties with NPI records 3

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

Corporate family (same tax ID) 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2322672Ozark Tri-County Healthcare Dba Access Family Care
805 Broadway, Lamar, MO 64759		Certificate of waiverApr 23, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Federally qualified health center certification: CCN 791189

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
Jan 13, 2022
Last certification
Jan 13, 2022
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Enrollment address
805 Broadway St
Lamar, MO 64759-1224

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.

NameRoleSinceShare
Julia M Leibbrand
Individual 		W-2 Managing Employee
Provider Enrollment		 Aug 13, 2014
Robin a Chapman
Individual 		Corporate Director
Board Member		 Feb 23, 2023
Sheila R Long
Individual 		Corporate Officer
Cfo		 May 14, 2007
W-2 Managing Employee
Cfo		 May 14, 2007
Amanda K Bearden
Individual 		Corporate Director
Board Member		 Aug 22, 2024
Keenan T Cortez
Individual 		Corporate Director
Board Member		 Aug 26, 2021
Jerrie Wise
Individual 		Corporate Director
Board Chair		 Jun 15, 1996
Kala M Smith
Individual 		Corporate Officer
Chief Dental Officer		 Jul 18, 2011
W-2 Managing Employee
Chief Dental Officer		 Jul 18, 2011
Joshua J Shackles
Individual 		Corporate Director
Board Vice Chair		 Aug 26, 2021
Elizabeth Persons
Individual 		Corporate Director
Board Secretary		 Nov 19, 2009
John M Seidel
Individual 		Corporate Director
Board Member		 Feb 22, 2024
Charla J Miles
Individual 		Corporate Director
Board Member		 Aug 22, 2024
Charles H Bentlage
Individual 		Corporate Director
Board Member		 Jan 28, 2021
Allison Pruitt
Individual 		Corporate Director
Board Member		 Feb 22, 2024
Jeffrey Elmore
Individual 		Corporate Officer
Cio		 May 30, 2017
W-2 Managing Employee
Cio		 May 30, 2017
Joseph Zuzul
Individual 		Corporate Director
Board Member		 Jul 25, 2019
John D Paulson
Individual 		Corporate Officer
Chief Medical Officer		 Nov 27, 2023
W-2 Managing Employee
MD;		 Nov 27, 2023
Christian Demasi
Individual 		Corporate Director
Board Member		 Jul 25, 2014
Carrie E Foote
Individual 		Corporate Officer
Risk Compliance and Quality Dir.		 Oct 3, 2021
W-2 Managing Employee
Risk Compliance and Quality Dir.		 Oct 2, 2006
Rosario Keele
Individual 		Corporate Director
Board Member		 Feb 22, 2024
Donald McBride
Individual 		Corporate Officer
Ceo		 Feb 27, 2006
W-2 Managing Employee
Ceo		 Feb 27, 2006
Carmen K Brown
Individual 		Corporate Director
Board Member		 Mar 25, 2011

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220106002649 MO Part a Provider - Federally Qualified Health Center (FQHC) 8123918257 Practice locations: Lamar, MO

National Provider Directory

Tax ID family
Ozark Tri-County Consortium (47 organizations share this tax ID)

Locations

805 Broadway St
Lamar, MO 64759
Phone (417) 262-6070

Specialties & licenses

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

Addresses

Primary practice location

805 Broadway St
Lamar, MO 64759-1224

Mailing address

PO Box 758
Neosho, MO 64850-0758
Phone (417) 451-9450

Other names

  • Access Family Care Doing business as

Other providers in Lamar, MO

All providers in Lamar, MO · Federally Qualified Health Center (FQHC) in Missouri

Sources for this page

Verify at the official NPI Registry.