Organization Active NPI

Health-1 LLC

  • Family Medicine Physician
  • Columbia, MO
National Provider Identifier
1396591202
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HEALTH-1 LLC
Practice address
1000 W Nifong Blvd Ste 120
Columbia, MO 65203-5615
Phone
(573) 444-6331
Fax
(855) 576-4137
NPI assigned
Apr 30, 2024
Last updated
Dec 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
John FernandoNPI 1487049250
Title
Owner
Phone
(573) 355-2429

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

1000 W Nifong Blvd Ste 120
Columbia, MO 65203-5615

Mailing address

1000 W Nifong Blvd Ste 120
Columbia, MO 65203-5615
Phone (573) 444-6331

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240729001131 MO Part B Supplier - Clinic/Group Practice 6204372022 Receives reassigned benefits from 3 practitioners
Practice locations: Columbia, MO

National Provider Directory

National Provider Directory

Locations

1000 W Nifong Blvd
Ste 120
Columbia, MO 65203
Phone (573) 268-5725

Practitioners & affiliated clinicians

Practitioners 3

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": "1714435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1396591202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W NIFONG BLVD STE 120",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035615",
            "telephone_number": "573-444-6331",
            "fax_number": "855-576-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W NIFONG BLVD STE 120",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035615",
            "telephone_number": "573-444-6331",
            "fax_number": "855-576-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH-1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "FERNANDO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-355-2429"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.