NPIMap

Organization Active NPI

St. Hope Foundation, Inc.

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
National Provider Identifier
1457782021
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ST. HOPE FOUNDATION, INC.
Practice address
255 Northpoint Dr
Suite 200
Houston, TX 77060-3203
Phone
(713) 300-8040
Fax
(713) 300-8041
NPI assigned
Dec 9, 2013
Last updated
May 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Authorized official

Name
Mr. Rodney Goodie
Title
Chief Executive Officer
Phone
(713) 778-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

255 Northpoint Dr
Suite 200
Houston, TX 77060-3203

Mailing address

6200 Savoy Dr
Suite 540
Houston, TX 77036-3338
Phone (713) 778-1300

Other identifiers 1

IdentifierTypeStateIssuer
3305880-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040219000896 TX Part B Supplier - Clinic/Group Practice 4880508878 Receives reassigned benefits from 19 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sugar Land, TX; Conroe, TX; Jersey Village, TX; Houston, TX; Dickinson, TX; Bellaire, TX
O20140425000072 TX Part A Provider - Federally Qualified Health Center (FQHC) 4880508878 Practice locations: Houston, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457782021. Details of each certification follow.

Federally qualified health center certification: CCN 741842

Legal name
ST. HOPE FOUNDATION INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 25, 2014
Last certification
Apr 25, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 4, 1999 in TX
Enrollment address
255 Northpoint Dr
Houston, TX 77060-3268

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
St Hope Pharmacy16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Rodney Goodie Individual 5% Or Greater Direct Ownership Interest Nov 1, 2013 100%
5% Or Greater Mortgage Interest Nov 1, 2013 100%
5% Or Greater Security Interest Nov 1, 2013 100%
Corporate OfficerChief Executive Officer Nov 1, 2013 100%
Operational/Managerial Control Nov 1, 2013 100%
Timika R Sam Cooper Individual Corporate OfficerChief Operating Officer Nov 1, 2013 100%
W-2 Managing Employee Nov 1, 2013 100%
St. Hope Foundation Inc Organization, Houston, TX 5% Or Greater Direct Ownership Interest Nov 1, 2013 100%
5% Or Greater Security Interest Nov 1, 2013 100%

Owners & managing parties with NPI records 4

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

  • St Hope Foundation Inc
    • Federally Qualified Health Center (FQHC)
    • Conroe, TX
    • NPI 1265581144

    5% Or Greater Direct Ownership Interest, 5% Or Greater Security Interest

    CMS ownership
  • St Hope Foundation Inc
    • Federally Qualified Health Center (FQHC)
    • Sugar Land, TX
    • NPI 1992869846

    5% Or Greater Direct Ownership Interest, 5% Or Greater Security Interest

    CMS ownership
  • St. Hope Foundation, Inc
    • Federally Qualified Health Center (FQHC)
    • Jersey Village, TX
    • NPI 1952078990

    5% Or Greater Direct Ownership Interest, 5% Or Greater Security Interest

    CMS ownership
  • St. Hope Foundation, Inc.
    • Federally Qualified Health Center (FQHC)
    • Bellaire, TX
    • NPI 1558479683

    5% Or Greater Direct Ownership Interest, 5% Or Greater Security Interest

    CMS ownership

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St. Hope Foundation IncConroe, TX, CCN 741966 Federally qualified health center Operational/Managerial Control (100%) Jul 1, 2016
St. Hope Foundation IncSugar Land, TX, CCN 741968 Federally qualified health center Operational/Managerial Control (100%) Jul 1, 2016
St. Hope Foundation IncJersey Village, TX, CCN 451178 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Security Interest (100%)		 Nov 24, 2021
Nov 24, 2021

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1457782021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 SAVOY DR",
            "address_2": "SUITE 540",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770363338",
            "telephone_number": "713-778-1300",
            "fax_number": "713-778-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 NORTHPOINT DR",
            "address_2": "SUITE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770603203",
            "telephone_number": "713-300-8040",
            "fax_number": "713-300-8041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. HOPE FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-09",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "GOODIE",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "713-778-1300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3305880-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.