Centralia Family Health Clinic – Rural Health Clinic/Center, NPI 1164615316
Rural Health Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Centralia Family Health Clinic
670, Mason Ridge Center Drive, Town and Country, Saint Louis County, Missouri, 63141, United States
SUITE 300
SAINT LOUIS, MO 631418573
Phone: (314) 996-7644
Fax: (314) 996-7658
Type: Mailing
1600 E BROADWAY
COLUMBIA, MO 652015844
Phone: (573) 815-6245
Type: Mailing
1021 E HIGHWAY 22
CENTRALIA, MO 652401183
Phone: (573) 682-5580
Fax: (573) 682-1539
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-08-31 (284 days ago).
Enrollment records
1
Earliest due date
2025-08-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040220001157 | O | Clinic/Group Practice | MO | 2025-08-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63141)
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