NORTHEAST MISSOURI HEALTH COUNCIL INC. NPI 1104829498

NPI Information

  • NPI: 1104829498
  • Provider Name: NORTHEAST MISSOURI HEALTH COUNCIL, INC.
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Doing Business As: NORTHEAST FAMILY HEALTH CLINICS
  • Address: 1416 CROWN DRIVE
    KIRKSVILLE, MO
    ZIP 63501
  • Phone: (660) 627-5757

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NPI Details

NORTHEAST MISSOURI HEALTH COUNCIL, INC. is a federally qualified health center (fqhc) clinic center in Kirksville, MO. NORTHEAST MISSOURI HEALTH COUNCIL, INC. NPI is 1104829498. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Northeast Family Health Clinics.

The provider's business location address is:

1416 CROWN DRIVE
KIRKSVILLE, MO
ZIP 63501-548
Phone: (660) 627-5757
Fax: (660) 627-5802

The provider's authorized official is Andrew H. Grimm .
The authorized official title is Executive Director and has the following contact phone number (660) 627-5757.

The enumeration date for this NPI number is 5/31/2005 and was last updated on 6/24/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessional2003032101MISSOURINo
21041C0700XSocial WorkerClinical002241MISSOURINo
3122300000XDentist2001012903MISSOURINo
4122300000XDentist2006007559MISSOURINo
5124Q00000XDental Hygienist003847MISSOURINo
6207Q00000XFamily MedicineR5E64MISSOURINo
7207Q00000XFamily Medicine2001023603MISSOURINo
8207Q00000XFamily MedicineR5C53MISSOURINo
9207Q00000XFamily MedicineR9D62MISSOURINo
10207V00000XObstetrics & Gynecology2004027805MISSOURINo
11208000000XPediatrics2006022612MISSOURINo
12208000000XPediatrics2005037590MISSOURINo
13363L00000XNurse Practitioner107529MISSOURINo
14363LF0000XNurse PractitionerFamily096968MISSOURINo
15261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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