NPIMap

Organization Active NPI

Tomagwa Ministries, Inc

  • Federally Qualified Health Center (FQHC)
  • Magnolia, TX
National Provider Identifier
1194314286
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TOMAGWA MINISTRIES, INC
Practice address
18230 FM 1488 Rd Ste 203
Magnolia, TX 77354-4530
Phone
(832) 559-5260
NPI assigned
Jan 13, 2021
Organization subpart
Yes
Parent organization
TOMAGWA MINISTIRES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Authorized official

Name
Timika Simmons
Title
Ceo
Phone
(832) 559-5223

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

18230 FM 1488 Rd Ste 203
Magnolia, TX 77354-4530

Mailing address

455 School St Ste 30
Tomball, TX 77375-4595
Phone (832) 559-5233

Other names 1

  • TOMAGWA HealthCare Ministires Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240819003101 TX Part A Provider - Federally Qualified Health Center (FQHC) 2365850872 Practice locations: Magnolia, TX

Federally qualified health center certification: CCN 971018

Legal name
TOMAGWA MINISTRIES INC
Doing business as
TOMAGWA AT MAGNOLIA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 6, 2024
Last certification
Aug 6, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 14, 2020 in TX
Enrollment address
18230 FM 1488 Rd
Magnolia, TX 77354-4528

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Tomagwa Ministries Inc4 organizations share this tax ID, including this one
Part of
Tomagwa Ministries Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Kevin Rudolph Individual Corporate DirectorBoard President Jan 1, 2020
William Berger Individual Corporate DirectorSecretary Feb 4, 2020
Timika Simmons Individual Corporate OfficerCeo Jan 1, 2019
Corporate DirectorCeo Jan 1, 2019
W-2 Managing EmployeeCeo Jan 1, 2019
Linda Whidden Flower Individual Corporate DirectorMedical Director Jan 1, 2010

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1194314286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 SCHOOL ST STE 30",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773754595",
            "telephone_number": "832-559-5233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18230 FM 1488 RD STE 203",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773544530",
            "telephone_number": "832-559-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMAGWA MINISTRIES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TOMAGWA MINISTIRES, INC",
        "enumeration_date": "2021-01-13",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "TIMIKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-559-5223"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TOMAGWA HealthCare Ministires",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Magnolia, TX

Sources for this page

Verify at the official NPI Registry.