NPIMap

Organization Active NPI

Compass Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Raymore, MO
National Provider Identifier
1134711575
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMPASS HEALTH, INC.
Practice address
501 N Sunset
Raymore, MO 64083-9235
Phone
(888) 403-1071
NPI assigned
Feb 8, 2021
Last updated
Mar 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Teresa L Porter
Title
Credentialing Manager
Phone
(660) 890-8156

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

501 N Sunset
Raymore, MO 64083-9235

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (888) 403-1071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210311000295 MO Part A Provider - Federally Qualified Health Center (FQHC) 1951206754 Practice locations: Raymore, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1134711575. Details of each certification follow.

Federally qualified health center certification: CCN 791009

Legal name
COMPASS HEALTH INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 10, 2021
Last certification
Mar 10, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 26, 1974 in MO
Enrollment address
501 N Sunset LN
Raymore, MO 64083-9402

National Provider Directory

National Provider Directory
Tax ID family
Michael D Atkinson128 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joi Niedner Individual Corporate OfficerBoard Member Jun 1, 2025
Dennis Daugherty Individual Corporate OfficerBoard Member Jun 1, 2025
Rebecca Culler Individual Corporate OfficerBoard Member Jun 1, 2025
Robert Dawson Individual Corporate OfficerBoard Member Jun 1, 2025
Susan Bowles Individual Corporate OfficerBoard Member Jun 1, 2025
Rodney Reid Individual Corporate OfficerBoard Member Jun 1, 2025
Teresa L Porter Individual W-2 Managing EmployeeCredentialing Manager Mar 2, 2021
Shari Bax Individual Corporate OfficerBoard Member Jun 1, 2025
Ross Henson Individual Corporate OfficerBoard Member Jun 1, 2025
Tim Glasscock Individual Corporate OfficerBoard Member Jun 1, 2025
Kathy Carter Individual Corporate OfficerBoard Member Jun 1, 2025
Brian C Baker Individual Corporate OfficerBoard Member Jun 1, 2025
Tim Alan Larimore Individual Corporate OfficerBoard Member Jun 1, 2025
Leticia Villafain Individual Corporate OfficerBoard Member Jun 1, 2025
Alan W Stevens Individual Corporate DirectorExecutive VP Mar 2, 2021

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Compass Health IncSaint Peters, MO, CCN 261161 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 11, 2018

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1134711575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "888-403-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N SUNSET",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640839235",
            "telephone_number": "888-403-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-03-03",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "660-890-8156"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raymore, MO

Sources for this page

Verify at the official NPI Registry.