NPIMap

Organization Active NPI

Ozark Tri-County Health Care Consortium

Doing business as ACCESS Family Care

  • Federally Qualified Health Center (FQHC)
  • Aurora, MO
National Provider Identifier
1932545977
Registry record updated Nov 4, 2022
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
1810 South Carnation Dr.
Aurora, MO 65605
Phone
(417) 678-1260
Fax
(417) 678-1261
NPI assigned
May 17, 2013
Last updated
Nov 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Authorized official

Name
Don 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

1810 South Carnation Dr.
Aurora, MO 65605

Mailing address

PO Box 758
475 Nelson Ave.
Neosho, MO 65708
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 MO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040330001501 MO Part B Supplier - Clinic/Group Practice 8123918257 Receives reassigned benefits from 66 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Joplin, MO; Neosho, MO; Monett, MO; Lamar, MO; Cassville, MO; Aurora, MO; Anderson, MO
O20130619000166 MO Part A Provider - Federally Qualified Health Center (FQHC) 8123918257 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Neosho, MO
O20140214000383 MO Part A Provider - Federally Qualified Health Center (FQHC) 8123918257 Practice locations: Aurora, MO

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1932545977. Details of each certification follow.

Federally qualified health center certification: CCN 261064

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
Aug 1, 2013
Last certification
Aug 1, 2013
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Enrollment address
1120 Carl Sweeney Pkwy
Neosho, MO 64850-7443

Federally qualified health center certification: CCN 261069

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
Feb 25, 2014
Last certification
Feb 25, 2014
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Enrollment address
1810 S Carnation Dr
Aurora, MO 65605-2162

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory

Locations

1810 S Carnation Dr
Aurora, MO 65605
Phone (417) 678-1260

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 26, 2013
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 EmployeeChief Financial Officer Cfo 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 19, 1996
Corporate DirectorBoard Member Jun 19, 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 Treasurer Nov 19, 2009
Corporate DirectorBoard Member 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
Corporate OfficerChief Information Officer May 30, 2017
W-2 Managing EmployeeChief Information Officer 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
Corporate Director Jul 25, 2014
Carrie E Foote Individual Corporate OfficerRisk Compliance & Quality Director Oct 3, 2021
W-2 Managing EmployeeRisk Compliance & Quality Director Oct 3, 2021
Corporate OfficerRisk Compliance and Quality Dir. Oct 3, 2021
Rosario Keele Individual Corporate DirectorBoard Member Feb 22, 2024
Donald McBride Individual Corporate OfficerCeo May 20, 2013
W-2 Managing EmployeeCeo May 20, 2013
Corporate OfficerCeo Feb 27, 2006 100%
W-2 Managing EmployeeCeo Feb 26, 2014
Carmen K Brown Individual Corporate DirectorBoard Member Mar 25, 2011
Corporate DirectorBoard Member Nov 19, 2009

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 10

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": "1368748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1932545977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 758",
            "address_2": "475 NELSON AVE.",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "65708",
            "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": "1810 SOUTH CARNATION DR.",
            "city": "AURORA",
            "state": "MO",
            "postal_code": "65605",
            "telephone_number": "417-678-1260",
            "fax_number": "417-678-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARK TRI-COUNTY HEALTH CARE CONSORTIUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-17",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "DON",
        "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 Aurora, MO

Sources for this page

Verify at the official NPI Registry.