Northeast Family Health – Federally Qualified Health Center (FQHC), NPI 1962548974

Northeast Family Health is a healthcare provider. based in Kirksville, Missouri. specializing in Federally Qualified Health Center (FQHC). The organization holds a License No. 002241 (MO). The NPI Number for Northeast Family Health is 1962548974

Main info

Organization
Name
Northeast Family Health
NPI
1962548974
Phone
(660) 627-5757
Address
1416 CROWN DRIVE
Authorized Official
ANDREW H GRIMM EXECUTIVE DIRECTOR
Enumeration Date
29 January 2007
Last Update Date
24 June 2011
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience78
Completeness80
Years active:19State licenses:7Digital endpointsUpdated within 12 months

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Provider Addresses for Northeast Family Health

  • 1416, Crown Drive, Kingsridge, Kirksville, Adair County, Missouri, 63501, United States

    KIRKSVILLE, MO 635012548

    Phone: (660) 627-5757

    Fax: (660) 627-5802

    Type: Mailing

  • 1506, Crown Drive, Kingsridge, Kirksville, Adair County, Missouri, 63501, United States

    KIRKSVILLE, MO 63501

    Phone: (660) 627-4493

    Fax: (660) 627-4288

    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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-09-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20060927000296OFederally Qualified Health Center (Fqhc)MOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 63501)

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Reviews

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Frequently asked questions

Is Northeast Family Health listed with a National Provider Identifier?
Yes — Northeast Family Health has NPI 1962548974 on file in the registry.
Active or inactive — what applies to Northeast Family Health?
You should see Northeast Family Health as active in CMS-hosted NPPES data.
What expertise is attributed to Northeast Family Health?
Northeast Family Health's specialty line reads Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
What locale is associated with Northeast Family Health?
Directory geography for Northeast Family Health centers on Kirksville, Missouri.
Can I trust this NPI listing for Northeast Family Health?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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