St Francis House Nwa, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Fayetteville, AR
NPI 1316639149 · NPPES record last updated Jun 27, 2023
Key facts
- NPI
- 1316639149
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- ST FRANCIS HOUSE NWA, INC
- Practice address
- 235 South Buchanan Avenue
Suite 1
Fayetteville, AR 72701 - Phone
- (479) 751-7417
- Fax
- (479) 751-2878
- NPI assigned
- May 22, 2023
- Organization subpart
- No
Authorized official
- Name
- James A Semingson
- Title
- Ceo
- Phone
- (479) 751-7417
Owners & managing parties with NPI records 1
-
James A Semingson II, CNP
Other NPIs on the same Medicare enrollment 8
Corporate family (same tax ID) 31
Practitioners 6
-
Kaylee M Armendariz, APRN-CNP
-
Gary Browning Berner, M.D.
-
Evelene Grace Bible, DNP FNP-BC
-
Roger W Youmans, M.D.
-
Stacy Johnson, MSN, APRN, FNP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D2284561 | Community Clinic Fayetteville High School | Provider-performed microscopy | Jun 25, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR
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
- Corporation · Non-profit
- Incorporated
- Jan 1, 1990 in AR
- Enrollment address
- 235 S Buchanan Ave
Ste 1
Fayetteville, AR 72701
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| St. Francis House Nwa, Inc. |
Other | Aug 30, 2023 | 100% |
| Sloan Scroggin |
Corporate Director |
Aug 30, 2023 | 10% |
| Carol Silva Moralez |
Corporate Director |
Aug 30, 2023 | 10% |
| Martha Anderson |
Corporate Director |
Aug 30, 2023 | 10% |
| Albert Barber |
Corporate Director |
Aug 30, 2023 | 10% |
| Debby Thetford Nye |
Corporate Director |
Aug 30, 2023 | 10% |
| Sara Milford |
Corporate Director |
Aug 30, 2023 | 10% |
| James a Semingson |
W-2 Managing Employee |
Sep 7, 2018 | 10% |
| Mayra P Esquivel |
Corporate Director |
Aug 30, 2023 | 10% |
| Lynn Su Chen Wong |
Corporate Director |
Aug 30, 2023 | 10% |
| Andrew Branch |
Corporate Director |
Aug 30, 2023 | 10% |
All facility ownership & control disclosures 17
| Facility | Type | Role | Since |
|---|---|---|---|
| Owl Creek School Based Health Center |
Federally qualified health center | Other (100%) | Apr 3, 2014 |
| Jones School Based Health Center |
Federally qualified health center | Other (100%) | May 20, 2014 |
| Siloam Springs School Based Health Center |
Federally qualified health center | Other (100%) | Jun 26, 2014 |
| Prairie Grove School Based Health Center |
Federally qualified health center | Other (100%) | Aug 4, 2014 |
| Community Clinic Springdale Medical Family Practice |
Federally qualified health center | Other (100%) | Aug 26, 2014 |
| George Elementary School Based Health Center |
Federally qualified health center | Other (100%) | Dec 9, 2014 |
| Elmdale School Based Health Center |
Federally qualified health center | Other (100%) | May 12, 2015 |
| Community Clinic Fayetteville Medical |
Federally qualified health center | Other (100%) | Nov 2, 2015 |
| Parson Hills School Based Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Oct 24, 2019 |
| Community Clinic Pea Ridge |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Aug 5, 2020 |
| Community Clinic Don Tyson School of Innovation |
Federally qualified health center | Operational/Managerial Control (100%) | Feb 14, 2022 |
| Community Clinic Elkins |
Federally qualified health center | Other (100%) | May 1, 2022 |
| Community Clinic Centerton |
Federally qualified health center | Other (100%) | Nov 28, 2022 |
| Advanced Health & Wellness I |
Federally qualified health center | Other (100%) | Jan 1, 2024 |
| Community Clinic Central Junior High |
Federally qualified health center | Other (100%) | Jul 17, 2024 |
| Community Clinic West Fork |
Federally qualified health center | Other (100%) | Oct 1, 2024 |
| Community Clinic Rogers Heritage |
Federally qualified health center | Other (100%) | Apr 6, 2026 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- St Francis House Nwa Inc
Locations
2630 E Citizens Dr
Ste 3
Fayetteville, AR 72703
Phone (479) 527-9966
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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
- COMMUNITY CLINIC FAYETTEVILLE HIGH SCHOOL
Other providers in Fayetteville, AR
- Springfield Neurological Institute, L.L.C.
- Kathryn Louise Sprouse
- Mariah B Squires
- St Francis House Nwa, Inc
- St Francis House Nwa, Inc
- St Francis House Nwa, Inc
- St Francis House Nwa, Inc
- St Francis House Nwa, Inc
- Devin Dean St. Clair
- Kevin L St. Clair
All providers in Fayetteville, AR · Federally Qualified Health Center (FQHC) in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.