NPIMap

Organization Active NPI

Willow Health Care Inc

Doing business as Westwood Rural Health Clinic

  • Rural Health Clinic/Center
  • Willow Springs, MO
National Provider Identifier
1184625782
Registry record updated Jul 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WILLOW HEALTH CARE INC
Doing business as
Westwood Rural Health Clinic
Practice address
2642 State Route 76
Willow Springs, MO 65793-8254
Phone
(417) 469-0204
Fax
(417) 469-3443
NPI assigned
Aug 3, 2005
Last updated
Jul 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2011

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

Authorized official

Name
Mrs. Sherry Miller, CPA
Title
Chief Financial Officer
Phone
(417) 469-0204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

2642 State Route 76
Willow Springs, MO 65793-8254

Mailing address

PO Box 309
Willow Springs, MO 65793-0309
Phone (417) 469-0204

Other identifiers 1

IdentifierTypeStateIssuer
591474101MedicaidMO

Other names 1

  • Westwood Rural Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230126003075 MO Part A Provider - Rural Health Clinic 2062401466 Practice locations: Willow Springs, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184625782. Details of each certification follow.

Rural health clinic certification: CCN 793860

Legal name
WILLOW HEALTH CARE INC
Doing business as
WESTWOOD RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 17, 2022
Last certification
Oct 19, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1978 in MO
Enrollment address
2646 State Route 76
Box 309
Willow Springs, MO 65793-8254

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0881050Westwood Rural Health Clinic2642 State Route 76, Willow Springs, MO 65793Certificate of waiverJan 27, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1211 N Ash St
#879
Mountain View, MO 65548
Phone (417) 469-0204

2642 State Route 76
Willow Springs, MO 65793
Phone (417) 469-0204

2642 State Route 76
#309
Willow Springs, MO 65793
Phone (417) 469-4035

2646 State Route 76
#309
Willow Springs, MO 65793
Phone (417) 469-0204

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Willow Health Care Inc Organization, Willow Springs, MO Non-profit 5% Or Greater Direct Ownership Interest Dec 2, 2009
James Ogden Individual Corporate Director Dec 2, 2009
Jackie Williamson Individual W-2 Managing Employee Dec 2, 2009
Shirley Alter Individual Corporate Director Jul 2, 2019
W-2 Managing EmployeeCeo Jul 2, 2019 100%
Linda Tooley Individual W-2 Managing Employee Aug 23, 2010
Sherry Miller Individual Corporate Director Dec 2, 2009
W-2 Managing Employee Dec 2, 2009
Sheila Clark Individual W-2 Managing Employee Aug 23, 2010

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Brooke Haven HealthcareWest Plains, MO, CCN 265400 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 1, 2003
Nov 1, 2003
Mountain View HealthcareMountain View, MO, CCN 265412 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 22, 2009
Willow Care Nursing HomeWillow Springs, MO, CCN 265335 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 2, 2009
Ozark Riverview ManorOzark, MO, CCN 265464 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2015
Oct 1, 2015
Westwood Home HealthWillow Springs, MO, CCN 267505 Home health agency 5% Or Greater Direct Ownership Interest (100%) Dec 2, 2009

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311292800000",
    "number": "1184625782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657930309",
            "telephone_number": "417-469-0204",
            "fax_number": "417-469-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2642 STATE ROUTE 76",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657938254",
            "telephone_number": "417-469-0204",
            "fax_number": "417-469-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2011-07-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "417-469-0204",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "591474101",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westwood Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willow Springs, MO

Sources for this page

Verify at the official NPI Registry.