{"npi":"1104829498","type":"NPI-2","status":"active","name":{"display":"Northeast Missouri Health Council, Inc.","other":[],"organization_name":"NORTHEAST MISSOURI HEALTH COUNCIL, INC.","authorised_official":"Andrew Grimm"},"specialty":{"primary_taxonomy":"261QF0400X","primary_taxonomy_description":"Federally Qualified Health Center","slug":"fqhc","schema_org_specialty":"PrimaryCare","all":[{"code":"101YP2500X","description":"Professional Counselor","primary":false,"state":"MO","license":"2003032101"},{"code":"1041C0700X","description":"Clinical Social Worker","primary":false,"state":"MO","license":"002241"},{"code":"122300000X","description":"Dentist","primary":false,"state":"MO","license":"2001012903"},{"code":"122300000X","description":"Dentist","primary":false,"state":"MO","license":"2006007559"},{"code":"124Q00000X","description":"Dental Hygienist","primary":false,"state":"MO","license":"003847"},{"code":"207Q00000X","description":"Family Medicine","primary":false,"state":"MO","license":"R5E64"},{"code":"207Q00000X","description":"Family Medicine","primary":false,"state":"MO","license":"2001023603"},{"code":"207Q00000X","description":"Family Medicine","primary":false,"state":"MO","license":"R5C53"},{"code":"207Q00000X","description":"Family Medicine","primary":false,"state":"MO","license":"R9D62"},{"code":"207V00000X","description":"Obstetrics & Gynecology","primary":false,"state":"MO","license":"2004027805"},{"code":"208000000X","description":"Pediatrics","primary":false,"state":"MO","license":"2006022612"},{"code":"208000000X","description":"Pediatrics","primary":false,"state":"MO","license":"2005037590"},{"code":"363L00000X","description":"Nurse Practitioner","primary":false,"state":"MO","license":"107529"},{"code":"363LF0000X","description":"Family Nurse Practitioner","primary":false,"state":"MO","license":"096968"},{"code":"261QF0400X","description":"Federally Qualified Health Center","primary":true,"state":"MO","license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"1416 CROWN DRIVE","city":"KIRKSVILLE","state":"MO","postal_code":"635012548","country_code":"US","phone":"6606275757","fax":"6606275802"},{"purpose":"MAILING","street_1":"1416 CROWN DRIVE","city":"KIRKSVILLE","state":"MO","postal_code":"635012548","country_code":"US","phone":"6606275757","fax":"6606275802"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20040112000061","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"MO","pac_id":"1658280805"},{"enrlmt_id":"O20040430000892","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"MO","pac_id":"1658280805"}]},"enumeration_date":"2005-05-31","last_updated":"2011-06-24","_meta":{"source":"NPPES","snapshot_date":"2011-06-24","doc_url":"https://findmynpi.com/api"}}