NPIMap

Organization Active NPI

Ozark Tri-County Health Care Consortium

Doing business as Access Family Care

  • Federally Qualified Health Center (FQHC)
  • Lamar, MO
National Provider Identifier
1891452835
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OZARK TRI-COUNTY HEALTH CARE CONSORTIUM
Doing business as
Access Family Care
Practice address
805 Broadway St
Lamar, MO 64759-1224
Phone
(417) 262-6070
Fax
(417) 262-6071
NPI assigned
Nov 24, 2021
Last updated
Sep 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Authorized official

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

Specialties & licenses 1

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

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 1

  • Access Family Care Doing business as

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891452835. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
805 Broadway St
Lamar, MO 64759-1224

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2322672Ozark Tri-County Healthcare Dba Access Family Care805 Broadway, Lamar, MO 64759Certificate of waiverApr 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ozark Tri County Health Care Consortium47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

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

View all 46

Locations

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

Ownership & related parties

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 EmployeeProvider Enrollment Aug 13, 2014
Robin a Chapman Individual Corporate DirectorBoard Member Feb 23, 2023
Sheila R Long Individual Corporate OfficerCfo May 14, 2007
W-2 Managing EmployeeCfo May 14, 2007
Amanda K Bearden Individual Corporate DirectorBoard Member Aug 22, 2024
Keenan T Cortez Individual Corporate DirectorBoard Member Aug 26, 2021
Jerrie Wise Individual Corporate DirectorBoard Chair Jun 15, 1996
Kala M Smith Individual Corporate OfficerChief Dental Officer Jul 18, 2011
W-2 Managing EmployeeChief Dental Officer Jul 18, 2011
Joshua J Shackles Individual Corporate DirectorBoard Vice Chair Aug 26, 2021
Elizabeth Persons Individual Corporate DirectorBoard Secretary Nov 19, 2009
John M Seidel Individual Corporate DirectorBoard Member Feb 22, 2024
Charla J Miles Individual Corporate DirectorBoard Member Aug 22, 2024
Charles H Bentlage Individual Corporate DirectorBoard Member Jan 28, 2021
Allison Pruitt Individual Corporate DirectorBoard Member Feb 22, 2024
Jeffrey Elmore Individual Corporate OfficerCio May 30, 2017
W-2 Managing EmployeeCio May 30, 2017
Joseph Zuzul Individual Corporate DirectorBoard Member Jul 25, 2019
John D Paulson Individual Corporate OfficerChief Medical Officer Nov 27, 2023
W-2 Managing EmployeeMD; Nov 27, 2023
Christian Demasi Individual Corporate DirectorBoard Member Jul 25, 2014
Carrie E Foote Individual Corporate OfficerRisk Compliance and Quality Dir. Oct 3, 2021
W-2 Managing EmployeeRisk Compliance and Quality Dir. Oct 2, 2006
Rosario Keele Individual Corporate DirectorBoard Member Feb 22, 2024
Donald McBride Individual Corporate OfficerCeo Feb 27, 2006
W-2 Managing EmployeeCeo Feb 27, 2006
Carmen K Brown Individual Corporate DirectorBoard Member Mar 25, 2011

Owners & managing parties with NPI records 3

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1891452835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 758",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648500758",
            "telephone_number": "417-451-9450",
            "fax_number": "417-451-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 BROADWAY ST",
            "city": "LAMAR",
            "state": "MO",
            "postal_code": "647591224",
            "telephone_number": "417-262-6070",
            "fax_number": "417-262-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARK TRI-COUNTY HEALTH CARE CONSORTIUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-24",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-451-9450"
    },
    "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": "Access Family Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Access Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lamar, MO

Sources for this page

Verify at the official NPI Registry.