NPIMap

Organization Active NPI

Compass Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, MO
National Provider Identifier
1275670747
Registry record updated Sep 15, 2020
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
1101 N Providence Rd
Columbia, MO 65203-4365
Phone
(573) 277-7899
Fax
(573) 442-5208
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

1101 N Providence Rd
Columbia, MO 65203-4365

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131

Other identifiers 1

IdentifierTypeStateIssuer
505384107MedicaidMO

Other names 1

  • Family Dental Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240124000951 MO Part A Provider - Federally Qualified Health Center (FQHC) 1951206754 Practice locations: Columbia, MO

Federally qualified health center certification: CCN 261973

Legal name
COMPASS HEALTH INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 15, 2024
Last certification
Feb 15, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 26, 1974 in MO
Enrollment address
1101 N Providence Rd
Columbia, MO 65203-4365

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
26D2333879Compass Health - Columbia N Providence1101 North Providence Road, Columbia, MO 65203Certificate of waiverNov 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Pathways Community Beha126 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 14

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 Jan 15, 2024
Dennis Daugherty Individual Corporate OfficerBoard Member Jan 15, 2024
Rebecca Culler Individual Corporate OfficerBoard Member Jan 15, 2024
Robert Dawson Individual Corporate OfficerBoard Member Jan 15, 2024
Rodney Reid Individual Corporate OfficerBoard Member Jan 15, 2024
Teresa L Porter Individual W-2 Managing EmployeeCredentialing Manager Jan 15, 2024
Shari Bax Individual Corporate OfficerBoard Member Jan 15, 2024
Tim Glasscock Individual Corporate OfficerBoard Member Jan 15, 2024
Patricia Cleveland Individual Corporate OfficerBoard Member Jan 15, 2024
Kathy Carter Individual Corporate OfficerBoard Member Jan 15, 2024
Brian C Baker Individual Corporate OfficerBoard Member Jan 15, 2024
Tim Alan Larimore Individual Corporate OfficerBoard Member Jan 15, 2024
Leticia Villafain Individual Corporate OfficerBoard Member Jan 15, 2024
Alan W Stevens Individual Corporate DirectorExecutive VP Jan 15, 2024

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": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1275670747",
    "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": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N PROVIDENCE RD",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034365",
            "telephone_number": "573-277-7899",
            "fax_number": "573-442-5208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "505384107",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.