NPIMap

Organization Active NPI

St Francis House Nwa, Inc

  • Federally Qualified Health Center (FQHC)
  • Pea Ridge, AR
National Provider Identifier
1669099073
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ST FRANCIS HOUSE NWA, INC
Practice address
1923 W Pickens Road
Pea Ridge, AR 72751
Phone
(479) 751-7417
Fax
(479) 751-4898
NPI assigned
Jul 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Authorized official

Name
James Semingson
Title
Ceo
Phone
(479) 751-7417

Specialties & licenses 1

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

Addresses

Primary practice location

1923 W Pickens Road
Pea Ridge, AR 72751

Mailing address

614 E Emma Ave Ste 300
Springdale, AR 72764-4469
Phone (479) 751-7417

Other names 1

  • COMMUNITY CLINIC PEA RIDGE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090526000134 AR Part B Supplier - Clinic/Group Practice 0042262495 Receives reassigned benefits from 80 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Springdale, AR; Siloam Springs, AR; Centerton, AR; Fayetteville, AR; Pea Ridge, AR; Prairie Grove, AR; Rogers, AR
O20200916001627 AR Part A Provider - Federally Qualified Health Center (FQHC) 0042262495 Practice locations: Pea Ridge, AR

Federally qualified health center certification: CCN 041971

Legal name
ST. FRANCIS HOUSE NWA, INC.
Doing business as
COMMUNITY CLINIC PEA RIDGE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 14, 2020
Last certification
Sep 14, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1923 W Pickens Rd
Pea Ridge, AR 72751-2504

Other NPIs on the same Medicare enrollment 17

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

View all 17

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2190190Community Clinic Pea Ridge1923 W Pickens Road, Pea Ridge, AR 72751Provider-performed microscopyAug 10, 2026

National Provider Directory

National Provider Directory
Tax ID family
St Francis House Nwa Inc32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
St. Francis House Nwa, Inc. Organization, Springdale, AR 5% Or Greater Direct Ownership Interest Aug 5, 2020 100%
Sloan Scroggin Individual Corporate DirectorMember, Board of Directors Aug 30, 2023 8.33%
Carol Silva Moralez Individual Corporate DirectorVice-President, Board of Directo Jan 18, 2021 8.33%
Martha Anderson Individual Corporate DirectorMember, Board of Directors Aug 30, 2023 8.33%
Albert Barber Individual Corporate DirectorMember, Board of Directors Aug 30, 2023 8.33%
Debby Thetford Nye Individual Corporate DirectorSecretary, Board of Directors Aug 30, 2023 8.33%
Sara Milford Individual Corporate DirectorMember, Board of Directors Jan 18, 2021 8.33%
James a Semingson Individual W-2 Managing EmployeeCeo Jan 18, 2021 8.33%
Randolph Torres Individual Corporate DirectorMember, Board of Directors Jul 24, 2024 8.33%
Mayra P Esquivel Individual Corporate DirectorMember, Board of Directors Aug 30, 2023 8.33%
Jenny England Individual Corporate DirectorMember, Board of Directors Jul 24, 2024 8.33%
Lynn Su Chen Wong Individual Corporate DirectorMember, Board of Directors Aug 30, 2023 8.33%
Andrew Branch Individual Corporate DirectorPresident, Board of Directors Aug 30, 2023 8.33%

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 17

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

FacilityTypeRoleSince
Owl Creek School Based Health CenterFayetteville, AR, CCN 041886 Federally qualified health center Other (100%) Apr 3, 2014
Jones School Based Health CenterSpringdale, AR, CCN 041897 Federally qualified health center Other (100%) May 20, 2014
Siloam Springs School Based Health CenterSiloam Springs, AR, CCN 041896 Federally qualified health center Other (100%) Jun 26, 2014
Prairie Grove School Based Health CenterPrairie Grove, AR, CCN 041899 Federally qualified health center Other (100%) Aug 4, 2014
Community Clinic Springdale Medical Family PracticeSpringdale, AR, CCN 041900 Federally qualified health center Other (100%) Aug 26, 2014
George Elementary School Based Health CenterSpringdale, AR, CCN 041904 Federally qualified health center Other (100%) Dec 9, 2014
Elmdale School Based Health CenterSpringdale, AR, CCN 041906 Federally qualified health center Other (100%) May 12, 2015
Community Clinic Fayetteville MedicalFayetteville, AR, CCN 041909 Federally qualified health center Other (100%) Nov 2, 2015
Parson Hills School Based Health CenterSpringdale, AR, CCN 041965 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 24, 2019
Community Clinic Don Tyson School of InnovationSpringdale, AR, CCN 041001 Federally qualified health center Operational/Managerial Control (100%) Feb 14, 2022
Community Clinic ElkinsElkins, AR, CCN 041007 Federally qualified health center Other (100%) May 1, 2022
Community Clinic CentertonCenterton, AR, CCN 041017 Federally qualified health center Other (100%) Nov 28, 2022
Community Clinic Fayetteville High SchoolFayetteville, AR, CCN 041037 Federally qualified health center Other (100%) Aug 30, 2023
Advanced Health & Wellness IFayetteville, AR, CCN 041048 Federally qualified health center Other (100%) Jan 1, 2024
Community Clinic Central Junior HighSpringdale, AR, CCN 041074 Federally qualified health center Other (100%) Jul 17, 2024
Community Clinic West ForkWest Fork, AR, CCN 041076 Federally qualified health center Other (100%) Oct 1, 2024
Community Clinic Rogers HeritageRogers, AR, CCN 041107 Federally qualified health center Other (100%) Apr 6, 2026

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596499200000",
    "number": "1669099073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 E EMMA AVE STE 300",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727644469",
            "telephone_number": "479-751-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 W PICKENS ROAD",
            "city": "PEA RIDGE",
            "state": "AR",
            "postal_code": "72751",
            "telephone_number": "479-751-7417",
            "fax_number": "479-751-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST FRANCIS HOUSE NWA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A",
        "authorized_official_last_name": "SEMINGSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "479-751-7417"
    },
    "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": "COMMUNITY CLINIC PEA RIDGE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pea Ridge, AR

Sources for this page

Verify at the official NPI Registry.