Advocates for a Healthy Community Inc

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

1794 State Highway BB
Hollister, MO 65672-5423

Phone

(417) 831-0150

Fax

(417) 868-8798

NPI assigned

Nov 28, 2016

Organization subpart

No

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

Authorized official

Name

Kenneth Brooks Miller Jr.

Title

Ceo/President

Phone

(417) 851-1551

Specialties & licenses 1

Addresses

Other names 1

• Jordan Valley Community Health Center Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346783222. Details of each certification follow.

• CCN 261132 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 261132

Legal name

JORDAN VALLEY COMMUNITY HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jan 26, 2017

Last certification

Jan 26, 2017

Ownership / control type

Non-profit – church related

Facility address

1794 State Highway BB
Hollister, MO 65672

Locations

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1346783222",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1794 STATE HIGHWAY BB",
            "city": "HOLLISTER",
            "state": "MO",
            "postal_code": "656725423",
            "telephone_number": "417-831-0150",
            "fax_number": "417-868-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCATES FOR A HEALTHY COMMUNITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-28",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "BROOKS",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "417-851-1551",
        "authorized_official_name_suffix": "Jr."
    },
    "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": "Jordan Valley Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jordan Valley Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Acute Solutions LLC (Everwell Family Clinic)
• Advocates for a Healthy Community, Inc (Jordan Valley Community Health Center)
• Advocates for a Healthy Community, Inc (Jordan Valley Community Health Center)
• Agape Primary Care Inc
• Lori Ann Appleman-Eck, MSW, LCSW
• Lanae Danielle Beasley

• Federally Qualified Health Center (FQHC) in Hollister, MO
• Providers in Hollister, MO by specialty
• Federally Qualified Health Center (FQHC) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.