NPIMap

Organization Active NPI

Northwest Health Services, Inc

Doing business as Gower Family Medicine

  • Federally Qualified Health Center (FQHC)
  • Gower, MO
National Provider Identifier
1407360449
Registry record updated Nov 10, 2021
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
Doing business as
Gower Family Medicine
Practice address
313 S US Highway 169
Gower, MO 64454-9116
Phone
(816) 424-6427
Fax
(816) 416-3387
NPI assigned
Nov 29, 2017
Last updated
Nov 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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) 232-6818

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

313 S US Highway 169
Gower, MO 64454-9116

Mailing address

303 South US Hwy 169
Gower, MO 64454
Phone (816) 424-6427

Other names 1

  • Gower Family Medicine Doing business as

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…
O20180116000670 MO Part A Provider - Federally Qualified Health Center (FQHC) 7113835174 Practice locations: Gower, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407360449. Details of each certification follow.

Federally qualified health center certification: CCN 261153

Legal name
NORTHWEST HEALTH SERVICES INC
Doing business as
GOWER FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 15, 2018
Last certification
Jan 15, 2018
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
May 1, 1983 in MO
Enrollment address
313 S US Highway 169
Gower, MO 64454-9116

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

National Provider Directory

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

Other organizations with this tax ID 20

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

View all 20

Locations

5001 Lake Ave
Saint Joseph, MO 64504
Phone (816) 238-7788

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Tina R Taylor Individual Corporate OfficerCfo Feb 1, 2020 100%
W-2 Managing EmployeeCfo Feb 1, 2020 100%
Robin Moppin Individual W-2 Managing EmployeeBilling & Coding Manager Feb 1, 2020 100%
Operational/Managerial ControlBilling & Coding Manager Feb 1, 2020 100%

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": "1511913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1407360449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 SOUTH US HWY 169",
            "city": "GOWER",
            "state": "MO",
            "postal_code": "64454",
            "telephone_number": "816-424-6427",
            "fax_number": "816-416-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 S US HIGHWAY 169",
            "city": "GOWER",
            "state": "MO",
            "postal_code": "644549116",
            "telephone_number": "816-424-6427",
            "fax_number": "816-416-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-29",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A",
        "authorized_official_last_name": "YOUNGER",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "816-232-6818"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "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": "Gower Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gower, MO

Sources for this page

Verify at the official NPI Registry.