St Francis House Nwa, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Fayetteville, AR
NPI 1013384288 · NPPES record last updated Jan 15, 2020
Key facts
- NPI
- 1013384288
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- ST FRANCIS HOUSE NWA, INC
- Practice address
- 3162 W Martin Luther King Blvd
Suites 13 & 14
Fayetteville, AR 72704-7684 - Phone
- (479) 935-4834
- Fax
- (479) 751-2878
- NPI assigned
- Aug 24, 2015
- Organization subpart
- No
Authorized official
- Name
- James Semingson
- Title
- Ceo
- Phone
- (479) 751-7417
Owners & managing parties with NPI records 1
-
James A Semingson II, CNP
Other NPIs on the same Medicare enrollment 17
Corporate family (same tax ID) 31
Practitioners 3
-
Justina Arriaza, APRN
-
Mandy Clark, APRN
-
Sarah Carolyn Lechner, APRN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D2099298 | Community Clinic Fayetteville Medical | Provider-performed microscopy | Sep 18, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR
Federally qualified health center certification: CCN 041909
- Legal name
- ST. FRANCIS HOUSE NWA, INC.
- Doing business as
- COMMUNITY CLINIC FAYETTEVILLE MEDICAL
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Nov 2, 2015
- Last certification
- Nov 2, 2015
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 10, 1996 in AR
- Enrollment address
- 3162W Martin Luther King Blvd
Suites 13 & 14
Fayetteville, AR 72704-7686
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| St. Francis House Nwa, Inc. |
Other | Nov 2, 2015 | 100% |
| Sloan Scroggin |
Corporate Director |
Jun 1, 2022 | 10% |
| Carol Silva Moralez |
Corporate Director |
Feb 17, 2020 | 10% |
| Martha Anderson |
Corporate Director |
Jun 1, 2022 | 10% |
| Albert Barber |
Corporate Director |
Aug 30, 2023 | 10% |
| Debby Thetford Nye |
Corporate Director |
Jun 1, 2022 | 10% |
| Sara Milford |
Corporate Director |
Jan 8, 2019 | 10% |
| James a Semingson |
W-2 Managing Employee |
Jan 1, 2020 | 10% |
| Mayra P Esquivel |
Corporate Director |
Aug 30, 2023 | 10% |
| Lynn Su Chen Wong |
Corporate Director |
Aug 30, 2023 | 10% |
| Andrew Branch |
Corporate Director |
Jun 1, 2022 | 10% |
All facility ownership & control disclosures 17
| Facility | Type | Role | Since |
|---|---|---|---|
| Owl Creek School Based Health Center |
Federally qualified health center | Other (100%) | Apr 3, 2014 |
| Jones School Based Health Center |
Federally qualified health center | Other (100%) | May 20, 2014 |
| Siloam Springs School Based Health Center |
Federally qualified health center | Other (100%) | Jun 26, 2014 |
| Prairie Grove School Based Health Center |
Federally qualified health center | Other (100%) | Aug 4, 2014 |
| Community Clinic Springdale Medical Family Practice |
Federally qualified health center | Other (100%) | Aug 26, 2014 |
| George Elementary School Based Health Center |
Federally qualified health center | Other (100%) | Dec 9, 2014 |
| Elmdale School Based Health Center |
Federally qualified health center | Other (100%) | May 12, 2015 |
| Parson Hills School Based Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Oct 24, 2019 |
| Community Clinic Pea Ridge |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Aug 5, 2020 |
| Community Clinic Don Tyson School of Innovation |
Federally qualified health center | Operational/Managerial Control (100%) | Feb 14, 2022 |
| Community Clinic Elkins |
Federally qualified health center | Other (100%) | May 1, 2022 |
| Community Clinic Centerton |
Federally qualified health center | Other (100%) | Nov 28, 2022 |
| Community Clinic Fayetteville High School |
Federally qualified health center | Other (100%) | Aug 30, 2023 |
| Advanced Health & Wellness I |
Federally qualified health center | Other (100%) | Jan 1, 2024 |
| Community Clinic Central Junior High |
Federally qualified health center | Other (100%) | Jul 17, 2024 |
| Community Clinic West Fork |
Federally qualified health center | Other (100%) | Oct 1, 2024 |
| Community Clinic Rogers Heritage |
Federally qualified health center | Other (100%) | Apr 6, 2026 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090526000134 | AR | Part B Supplier - Clinic/Group Practice | 0042262495 |
Receives reassigned benefits from 80 practitioners 17 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Springdale, AR; Siloam Springs, AR; Centerton, AR; Fayetteville, AR; Pea Ridge, AR; Prairie Grove, AR; Rogers, AR |
| O20160114000131 | AR | Part a Provider - Federally Qualified Health Center (FQHC) | 0042262495 | Practice locations: Fayetteville, AR |
National Provider Directory
- Tax ID family
- St Francis House Nwa Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
3162 W Martin Luther King Blvd
Suites 13 & 14
Fayetteville, AR 72704-7684
Mailing address
614 E Emma Ave
Suite 300
Springdale, AR 72764-4634
Phone (479) 751-7417
Other names
- COMMUNITY CLINIC FAYETTEVILLE MEDICAL
Other providers in Fayetteville, AR
- Chelsey Nicole Spragins
- Springfield Neurological and Spine Institute
- Springfield Neurological Institute, L.L.C.
- Kathryn Louise Sprouse
- Mariah B Squires
- St Francis House Nwa, Inc
- St Francis House Nwa, Inc
- St Francis House Nwa, Inc
- St Francis House Nwa, Inc
- St Francis House Nwa, Inc
All providers in Fayetteville, AR · Federally Qualified Health Center (FQHC) in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.