NPIMap

Organization Active NPI

St Francis House Nwa, Inc

Doing business as Community Clinic Fayetteville High School

  • Federally Qualified Health Center (FQHC)
  • Fayetteville, AR
National Provider Identifier
1316639149
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ST FRANCIS HOUSE NWA, INC
Doing business as
Community Clinic Fayetteville High School
Practice address
235 South Buchanan Avenue
Suite 1
Fayetteville, AR 72701
Phone
(479) 751-7417
Fax
(479) 751-2878
NPI assigned
May 22, 2023
Last updated
Jun 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Authorized official

Name
James A SemingsonNPI 1841635596
Title
Ceo
Phone
(479) 751-7417

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

235 South Buchanan Avenue
Suite 1
Fayetteville, AR 72701

Mailing address

614 E Emma Ave Ste 300
Springdale, AR 72764-4469
Phone (479) 751-7417

Other names 1

  • COMMUNITY CLINIC FAYETTEVILLE HIGH SCHOOL Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220527002133 AR Part B Supplier - Clinic/Group Practice 0042262495 Receives reassigned benefits from 52 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Fork, AR; Siloam Springs, AR; Fayetteville, AR; Elkins, AR; Gentry, AR
O20230913001210 AR Part A Provider - Federally Qualified Health Center (FQHC) 0042262495 Practice locations: Fayetteville, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316639149. Details of each certification follow.

Federally qualified health center certification: CCN 041037

Legal name
ST. FRANCIS HOUSE NWA, INC.
Doing business as
COMMUNITY CLINIC FAYETTEVILLE HIGH SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 31, 2023
Last certification
Aug 31, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1990 in AR
Enrollment address
235 S Buchanan Ave
Ste 1
Fayetteville, AR 72701

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
04D2284561Community Clinic Fayetteville High School235 South Buchanan Ave Suite One, Fayetteville, AR 72701Provider-performed microscopyJun 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Family Medical Center33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

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

View all 32

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
St. Francis House Nwa, Inc. Organization, Springdale, AR Other Aug 30, 2023 100%
Sloan Scroggin Individual Corporate DirectorMember, Board of Directors Aug 30, 2023 10%
Carol Silva Moralez Individual Corporate DirectorVice-President, Board of Directors Aug 30, 2023 10%
Martha Anderson Individual Corporate DirectorMember, Board of Directors Aug 30, 2023 10%
Albert Barber Individual Corporate DirectorMember, Board of Directors Aug 30, 2023 10%
Debby Thetford Nye Individual Corporate DirectorSecretary, Board of Directors Aug 30, 2023 10%
Sara Milford Individual Corporate DirectorMember, Board of Directors Aug 30, 2023 10%
James a Semingson Individual W-2 Managing EmployeeCeo Sep 7, 2018 10%
Mayra P Esquivel Individual Corporate DirectorMember, Board of Directors Aug 30, 2023 10%
Lynn Su Chen Wong Individual Corporate DirectorMember, Board of Directors Aug 30, 2023 10%
Andrew Branch Individual Corporate DirectorPresident, Board of Directors Aug 30, 2023 10%

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 17

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

FacilityTypeRoleSince
Owl Creek School Based Health CenterFayetteville, AR, CCN 041886 Federally qualified health center Other (100%) Apr 3, 2014
Jones School Based Health CenterSpringdale, AR, CCN 041897 Federally qualified health center Other (100%) May 20, 2014
Siloam Springs School Based Health CenterSiloam Springs, AR, CCN 041896 Federally qualified health center Other (100%) Jun 26, 2014
Prairie Grove School Based Health CenterPrairie Grove, AR, CCN 041899 Federally qualified health center Other (100%) Aug 4, 2014
Community Clinic Springdale Medical Family PracticeSpringdale, AR, CCN 041900 Federally qualified health center Other (100%) Aug 26, 2014
George Elementary School Based Health CenterSpringdale, AR, CCN 041904 Federally qualified health center Other (100%) Dec 9, 2014
Elmdale School Based Health CenterSpringdale, AR, CCN 041906 Federally qualified health center Other (100%) May 12, 2015
Community Clinic Fayetteville MedicalFayetteville, AR, CCN 041909 Federally qualified health center Other (100%) Nov 2, 2015
Parson Hills School Based Health CenterSpringdale, AR, CCN 041965 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 24, 2019
Community Clinic Pea RidgePea Ridge, AR, CCN 041971 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 5, 2020
Community Clinic Don Tyson School of InnovationSpringdale, AR, CCN 041001 Federally qualified health center Operational/Managerial Control (100%) Feb 14, 2022
Community Clinic ElkinsElkins, AR, CCN 041007 Federally qualified health center Other (100%) May 1, 2022
Community Clinic CentertonCenterton, AR, CCN 041017 Federally qualified health center Other (100%) Nov 28, 2022
Advanced Health & Wellness IFayetteville, AR, CCN 041048 Federally qualified health center Other (100%) Jan 1, 2024
Community Clinic Central Junior HighSpringdale, AR, CCN 041074 Federally qualified health center Other (100%) Jul 17, 2024
Community Clinic West ForkWest Fork, AR, CCN 041076 Federally qualified health center Other (100%) Oct 1, 2024
Community Clinic Rogers HeritageRogers, AR, CCN 041107 Federally qualified health center Other (100%) Apr 6, 2026

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1316639149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 E EMMA AVE STE 300",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727644469",
            "telephone_number": "479-751-7417",
            "fax_number": "479-751-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 SOUTH BUCHANAN AVENUE",
            "address_2": "SUITE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72701",
            "telephone_number": "479-751-7417",
            "fax_number": "479-751-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST FRANCIS HOUSE NWA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "SEMINGSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "479-751-7417"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY CLINIC FAYETTEVILLE HIGH SCHOOL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COMMUNITY CLINIC FAYETTEVILLE HIGH SCHOOL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.