Compass Health, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Saint Peters, MO
NPI 1063998441 · NPPES record last updated Sep 15, 2020
Key facts
- NPI
- 1063998441
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- COMPASS HEALTH, INC.
- Practice address
- 8075 Mexico Rd
Saint Peters, MO 63376-1148 - Phone
- (573) 234-5258
- NPI assigned
- Jul 18, 2018
- Organization subpart
- No
Authorized official
- Name
- Teresa L Porter
- Title
- Credentialing Manager
- Phone
- (660) 890-8156
Corporate family (same tax ID) 22
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D2333838 | Compass Health - St Peter'S Express Care | Certificate of waiver | Nov 11, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Federally qualified health center certification: CCN 261161
- Legal name
- COMPASS HEALTH INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Aug 6, 2018
- Last certification
- Aug 6, 2018
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 3, 2004 in MO
- Enrollment address
- 8075 Mexico Rd
Saint Peters, MO 63376-1148
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Compass Health Inc |
5% Or Greater Direct Ownership Interest | Jul 11, 2018 | 100% |
| Teresa L Porter |
W-2 Managing Employee |
Jul 11, 2018 | |
| Alan W Stevens |
Corporate Director |
Jul 11, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180807001191 | MO | Part a Provider - Federally Qualified Health Center (FQHC) | 1951206754 | Practice locations: Saint Peters, MO |
National Provider Directory
- Tax ID family
- Pathways Community Beha
Locations
8075 Mexico Rd
Saint Peters, MO 63376
Phone (573) 234-5258
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
8075 Mexico Rd
Saint Peters, MO 63376-1148
Mailing address
1800 Community
Clinton, MO 64735-8804
Phone (660) 890-8156
Other providers in Saint Peters, MO
- Community Living, Inc.
- Community Living, Inc.
- Community Living, Inc.
- Community Services of Missouri Inc.
- Compass Health, Inc
- Complete Performance Chiropractic LLC
- Comprenhensive Family Dental, LLC
- Gretchen Lynn Compton
- Confluence Mental Healthcare LLC
- Kelli Marie Connor
All providers in Saint Peters, MO · Federally Qualified Health Center (FQHC) in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 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.