NPIMap

Organization Active NPI

Northwest Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Chillicothe, MO
National Provider Identifier
1336800515
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTHWEST HEALTH SERVICES INC
Practice address
300 W Business Hwy 36
Chillicothe, MO 64601
Phone
(816) 271-8265
NPI assigned
Jan 10, 2022
Last updated
Oct 26, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHWEST HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Authorized official

Name
Matt Younger
Title
Ceo
Phone
(816) 271-8265

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Clinical Social Worker 1041C0700X
General Practice Dentistry 1223G0001X
Family Medicine Physician 207Q00000X
Psychiatry Physician 2084P0800X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

300 W Business Hwy 36
Chillicothe, MO 64601

Mailing address

PO Box 803886
Kansas City, MO 64180-3886
Phone (816) 271-8265

Other names 2

  • Chillicothe Dental Clinic Other name
  • Chillicothe Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040720001347 MO Part B Supplier - Clinic/Group Practice 7113835174 Receives reassigned benefits from 24 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gower, MO; Savannah, MO; Saint Joseph, MO; King City, MO; Hamilton, MO; Braymer, MO; Chillicothe, MO; Cainsville, MO…
O20221129000155 MO Part A Provider - Federally Qualified Health Center (FQHC) 7113835174 Practice locations: Chillicothe, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336800515. Details of each certification follow.

Federally qualified health center certification: CCN 261919

Legal name
NORTHWEST HEALTH SERVICES INC
Doing business as
CHILLICOTHE HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 22, 2022
Last certification
Nov 22, 2022
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
May 1, 1983 in MO
Enrollment address
300 W Business 36
Chillicothe, MO 64601-3362

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Other NPIs on the same Medicare enrollment 16

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

View all 16

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
26D2256827Northwest Health Services, Inc300 West Business Hwy 36, Chillicothe, MO 64601Certificate of waiverMar 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
Northwest Health Services21 organizations share this tax ID, including this one
Part of
Northwest Health Services

Other organizations with this tax ID 20

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

View all 20

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Matthew W Younger Individual Corporate DirectorCeo Aug 7, 2020 100%
Kimberly Ireland Individual Corporate DirectorBoard of Directors Vice President Jan 1, 2020 100%
Steve Loucks Individual Corporate DirectorDirector Jan 1, 2020 100%
Sherry Weldon Individual Corporate DirectorBoard of Directors Secretary Jan 1, 2020 100%
Tina R Taylor Individual Corporate OfficerCfo Mar 1, 2016 100%
W-2 Managing EmployeeCfo Mar 1, 2016 100%
Robin Moppin Individual W-2 Managing EmployeeBilling Manager Feb 1, 2020 100%
Operational/Managerial ControlBilling Manager Feb 1, 2020 100%

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": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1336800515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 803886",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641803886",
            "telephone_number": "816-271-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W BUSINESS HWY 36",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "64601",
            "telephone_number": "816-271-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST HEALTH SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST HEALTH SERVICES, INC.",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "YOUNGER",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "816-271-8265"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "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": "Chillicothe Dental Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Chillicothe Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chillicothe, MO

Sources for this page

Verify at the official NPI Registry.