FORDLAND CLINIC, INC.
NPI 1639421365
Clinic/Center - Federally Qualified Health Center (FQHC) in Kimberling City, MO
About Fordland Clinic, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FORDLAND CLINIC, INC. (NPI 1639421365), doing business as Tri-lakes Community Health Center, is a healthcare organization registered as a federally qualified health center (fqhc) in Kimberling City, Missouri and active in the NPI registry since October 2012. The organization lists Teri Simmons, Billing/credentialing Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fordland Clinic, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
18Medicare enrollment records show 18 clinicians reassign Medicare billing to Fordland Clinic, Inc., which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians by Medicare Specialty 6
Clinicians, nearest first (18)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Fordland Clinic, Inc.'s NPI number?
The NPI number for Fordland Clinic, Inc. is 1639421365. It was assigned to this organization in the NPPES registry on October 4, 2012. The provider is doing business as Tri-Lakes Community Health Center.
Where is Fordland Clinic, Inc. located?
Fordland Clinic, Inc. is located at 11863 State Highway 13, Kimberling City, MO 65686. The listed phone number is (417) 739-1995.
What is Fordland Clinic, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Fordland Clinic, Inc. enrolled in Medicare?
Yes. Fordland Clinic, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Fordland Clinic, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 18 clinicians in 6 Medicare specialties reassign their Medicare billing to Fordland Clinic, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (7), Clinical Social Worker (3) and Family Practice (3). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Fordland Clinic, Inc. accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 3 other insurers list Fordland Clinic, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Fordland Clinic, Inc. was last updated on May 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Fordland Clinic, Inc. · NPI 1639421365
Federally Qualified Health Center (FQHC) organization in Kimberling City, Missouri. Organization record, active in the CMS NPPES registry since October 4, 2012.
## Identity
- **NPI:** 1639421365 (Entity type: Organization)
- **Enumerated:** October 4, 2012
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Also known as:** Tri-Lakes Community Health Center (Doing Business As)
- **Organization subpart:** Yes (part of Fordland Clinic, Inc.)
- **Authorized official:** Teri Simmons, BILLING/CREDENTIALING MANAGER
## Practice location
- **Address:** 11863 STATE HIGHWAY 13, Kimberling City, MO 65686
- **Phone:** (417) 739-1995
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 18 clinicians in 6 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (7), Clinical Social Worker (3), Family Practice (3); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 26, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1639421365) · Data from the CMS NPPES public registry.