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
1356424352
Registry record updated Aug 5, 2025
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
860 Lynn St
Lebanon, MO 65536-3810
Phone
(417) 334-8337
Fax
(417) 868-8798
NPI assigned
Oct 23, 2006
Last updated
Aug 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Authorized official

Name
Mr. Matthew Stinson, MDNPI 1366533937
Title
Ceo
Phone
(417) 831-1551

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

860 Lynn St
Lebanon, MO 65536-3810

Mailing address

440 E Tampa St
Springfield, MO 65806-1131
Phone (417) 831-0150

Other names 1

  • JORDAN VALLEY COMMUNITY HEALTH CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151014002508 MO Part A Provider - Federally Qualified Health Center (FQHC) 5395653562 Practice locations: Lebanon, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356424352. Details of each certification follow.

Federally qualified health center certification: CCN 261104

Legal name
ADVOCATES FOR A HEALTHY COMMUNITY INC
Doing business as
JORDAN VALLEY COMMUNITY HEALTH CENTER - LEBANON
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 13, 2015
Last certification
Oct 13, 2015
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Feb 21, 1992 in MO
Enrollment address
860 Lynn St
Lebanon, MO 65536-3810

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Amy Poe Individual Corporate DirectorBoard Member Aug 11, 2022
Jeff Davis Individual Corporate DirectorBoard Member Aug 11, 2022
Yadira Howe Individual W-2 Managing EmployeeExecutive Vice President, Adm Mar 20, 2024
Kenneth B Miller Individual Corporate OfficerCeo Aug 12, 2002
Christy Wilson Individual W-2 Managing EmployeeDirector, Revenue Cycle Mar 20, 2024
Mendie Schoeller Individual Corporate DirectorBoard Member Aug 11, 2022
Matthew Stinson Individual Corporate OfficerCeo Jun 1, 2024
Trey Peck Individual Corporate DirectorBoard Member Aug 11, 2022
Kevin Gipson Individual Corporate DirectorBoard Member Aug 11, 2022
John Twitty Individual Corporate OfficerChair Aug 11, 2022
Corporate DirectorBoard Member Jun 1, 2011
Phil Brown Individual Corporate OfficerBoard Member Jun 1, 2022
Richard Hardy Individual Corporate DirectorBoard Member Aug 11, 2022
Carol Dehaven Janick Individual Corporate OfficerSecretary/Treasurer Aug 11, 2022
Corporate DirectorBoard Member Aug 11, 2022
Mike Schnake Individual Corporate OfficerVice Chair Aug 11, 2022
Corporate DirectorBoard Member Jun 19, 2017
Rita Gurian Individual Corporate OfficerBoard Member Jun 1, 2022

Owners & managing parties with NPI records 1

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

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": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1356424352",
    "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": "417-831-0150",
            "fax_number": "417-868-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 LYNN ST",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655363810",
            "telephone_number": "417-334-8337",
            "fax_number": "417-868-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCATES FOR A HEALTHY COMMUNITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "STINSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-831-1551",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "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"
        }
    ]
}

Other providers in Lebanon, MO

Sources for this page

Verify at the official NPI Registry.