Compass Health, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Troy, MO
NPI 1073062592 · NPPES record last updated Mar 1, 2022
Key facts
- NPI
- 1073062592
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- COMPASS HEALTH, INC.
- Practice address
- 91 Troy SQ
Troy, MO 63379-3227 - Phone
- (844) 853-8937
- NPI assigned
- Sep 26, 2016
- Organization subpart
- No
Authorized official
- Name
- Teresa Porter
- Title
- Credentialing Manager
- Phone
- (660) 890-8156
Corporate family (same tax ID) 24
Practitioners 2
-
Amy Beck, MACL, LPC
-
Kim Dawn McMillian, APRN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D2333623 | Compass Health Troy | Certificate of waiver | Nov 6, 2027 |
| 26D2344195 | Compass Health Network - Troy | Certificate of waiver | May 18, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Federally qualified health center certification: CCN 261127
- Legal name
- COMPASS HEALTH INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Nov 29, 2016
- Last certification
- Nov 29, 2016
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 3, 2004 in MO
- Enrollment address
- 91 Troy SQ
Troy, MO 63379-3227
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Jacob Krafve |
Corporate Officer |
Oct 26, 2016 | |
| Teresa L Porter |
W-2 Managing Employee |
Oct 26, 2016 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Compass Health Inc |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jul 11, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161129001301 | MO | Part a Provider - Federally Qualified Health Center (FQHC) | 1951206754 | Practice locations: Troy, MO |
National Provider Directory
- Tax ID family
- Pathways Community Beha
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
91 Troy SQ
Troy, MO 63379-3227
Mailing address
1800 Community
Clinton, MO 64735-8804
Phone (660) 890-8186
Other names
- Pathways Community Behavioral Healthcare
Other providers in Troy, MO
- Community Opportunities
- Community Opportunities
- Community Opportunities
- Community Opportunities
- Community Opportunities
- Robert Bruce Cooper
- Counseling for Resolution LLC
- McKenna Lee Courtney
- Cross Couseling & Behavioral Health
- Cuivre Creek Pediatric Dentistry
All providers in Troy, 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 Mar 1, 2022. 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.