St Francis House Nwa, Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Siloam Springs, AR

NPI 1689436768 · NPPES record last updated Jan 25, 2024

Key facts

NPI
1689436768
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
ST FRANCIS HOUSE NWA, INC
Practice address
100 Broadhurst St
Siloam Springs, AR 72761-4081
Phone
(479) 373-1591
Fax
(479) 751-2878
NPI assigned
Jan 25, 2024
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 1

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

Other NPIs on the same Medicare enrollment 8

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

Corporate family (same tax ID) 31

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

View all 31

Practitioners 3

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in AR

Federally qualified health center certification: CCN 041062

Legal name
ST. FRANCIS HOUSE NWA, INC.
Doing business as
BROADHURST ST MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 7, 2024
Last certification
May 7, 2024
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Jan 1, 1990 in AR
Enrollment address
100 Broadhurst St
Siloam Springs, AR 72761-4081

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Sloan Scroggin
Individual
Corporate Director
Member, Board of Directors
Aug 30, 2023 10%
Carol Silva Moralez
Individual
Corporate Director
Vice-President, Board of Directors
Aug 30, 2023 10%
Martha Anderson
Individual
Corporate Director
Member, Board of Directors
Aug 30, 2023 10%
Albert Barber
Individual
Corporate Director
Member, Board of Directors
Aug 30, 2023 10%
Debby Thetford Nye
Individual
Corporate Director
Secretary, Board of Directors
Aug 30, 2023 10%
Sara Milford
Individual
Corporate Director
Member, Board of Directors
Aug 30, 2023 10%
James a Semingson
Individual
W-2 Managing Employee
Ceo
Sep 7, 2018 10%
Mayra P Esquivel
Individual
Corporate Director
Member, Board of Directors
Aug 30, 2023 10%
Lynn Su Chen Wong
Individual
Corporate Director
Member, Board of Directors
Aug 30, 2023 10%
Andrew Branch
Individual
Corporate Director
President, Board of Directors
Aug 30, 2023 10%

All facility ownership & control disclosures 18

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

FacilityTypeRoleSince
Owl Creek School Based Health Center
Fayetteville, AR · CCN 041886
Federally qualified health center Other (100%) Apr 3, 2014
Jones School Based Health Center
Springdale, AR · CCN 041897
Federally qualified health center Other (100%) May 20, 2014
Siloam Springs School Based Health Center
Siloam Springs, AR · CCN 041896
Federally qualified health center Other (100%) Jun 26, 2014
Prairie Grove School Based Health Center
Prairie Grove, AR · CCN 041899
Federally qualified health center Other (100%) Aug 4, 2014
Community Clinic Springdale Medical Family Practice
Springdale, AR · CCN 041900
Federally qualified health center Other (100%) Aug 26, 2014
George Elementary School Based Health Center
Springdale, AR · CCN 041904
Federally qualified health center Other (100%) Dec 9, 2014
Elmdale School Based Health Center
Springdale, AR · CCN 041906
Federally qualified health center Other (100%) May 12, 2015
Community Clinic Fayetteville Medical
Fayetteville, AR · CCN 041909
Federally qualified health center Other (100%) Nov 2, 2015
Parson Hills School Based Health Center
Springdale, AR · CCN 041965
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 24, 2019
Community Clinic Pea Ridge
Pea Ridge, AR · CCN 041971
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 5, 2020
Community Clinic Don Tyson School of Innovation
Springdale, AR · CCN 041001
Federally qualified health center Operational/Managerial Control (100%) Feb 14, 2022
Community Clinic Elkins
Elkins, AR · CCN 041007
Federally qualified health center Other (100%) May 1, 2022
Community Clinic Centerton
Centerton, AR · CCN 041017
Federally qualified health center Other (100%) Nov 28, 2022
Community Clinic Fayetteville High School
Fayetteville, AR · CCN 041037
Federally qualified health center Other (100%) Aug 30, 2023
Advanced Health & Wellness I
Fayetteville, AR · CCN 041048
Federally qualified health center Other (100%) Jan 1, 2024
Community Clinic Central Junior High
Springdale, AR · CCN 041074
Federally qualified health center Other (100%) Jul 17, 2024
Community Clinic West Fork
West Fork, AR · CCN 041076
Federally qualified health center Other (100%) Oct 1, 2024
Community Clinic Rogers Heritage
Rogers, AR · CCN 041107
Federally qualified health center Other (100%) Apr 6, 2026

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220527002133 AR Part B Supplier - Clinic/Group Practice 0042262495 Receives reassigned benefits from 52 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Fork, AR; Siloam Springs, AR; Fayetteville, AR; Elkins, AR; Gentry, AR
O20240429000523 AR Part a Provider - Federally Qualified Health Center (FQHC) 0042262495 Practice locations: Siloam Springs, AR

National Provider Directory

Tax ID family
St Francis House Nwa Inc (32 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

100 Broadhurst St
Siloam Springs, AR 72761-4081

Mailing address

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

Other names

  • BROADHURST ST. MEDICAL CLINIC Doing business as

Other providers in Siloam Springs, AR

All providers in Siloam Springs, AR · Federally Qualified Health Center (FQHC) in Arkansas

Sources for this page

Verify at the official NPI Registry.