NPIMap

Organization Active NPI

Advocates for a Healthy Community, Inc

Doing business as Jordan Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Lebanon, MO
National Provider Identifier
1326739418
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ADVOCATES FOR A HEALTHY COMMUNITY, INC
Doing business as
Jordan Valley Community Health Center
Practice address
2020 Evergreen Pkwy
Lebanon, MO 65536-4611
Phone
(417) 334-8337
Fax
(417) 832-8275
NPI assigned
May 18, 2023
Last updated
May 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Authorized official

Name
Kenneth Brooks Miller
Title
Ceo
Phone
(417) 851-1551

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2020 Evergreen Pkwy
Lebanon, MO 65536-4611

Mailing address

440 E Tampa St
Springfield, MO 65806-1131
Phone (417) 851-1551

Other names 1

  • Jordan Valley Community Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jordan Valley Community33 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

Locations

2020 Evergreen Pkwy
Lebanon, MO 65536
Phone (417) 334-8337

Practitioners & affiliated clinicians

Practitioners 1

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": "1684368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1326739418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E TAMPA ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061131",
            "telephone_number": "417-851-1551",
            "fax_number": "417-832-8275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 EVERGREEN PKWY",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655364611",
            "telephone_number": "417-334-8337",
            "fax_number": "417-832-8275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCATES FOR A HEALTHY COMMUNITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "BROOKS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-851-1551"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "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": "Jordan Valley Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.