NPIMap

Organization Active NPI

Advocates for a Healthy Community, Inc.

Doing business as Jordan Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Lebanon, MO
National Provider Identifier
1720566805
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ADVOCATES FOR A HEALTHY COMMUNITY, INC.
Doing business as
Jordan Valley Community Health Center
Practice address
860 Lynn St
Lebanon, MO 65536-3810
Phone
(417) 344-0062
NPI assigned
Aug 1, 2018
Last updated
Dec 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Authorized official

Name
Jo Anne Thompson
Title
Director of Finance
Phone
(417) 831-0150

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Clinic Pharmacy 3336C0002X 2017013552 MO

Addresses

Primary practice location

860 Lynn St
Lebanon, MO 65536-3810

Mailing address

440 E Tampa St
Springfield, MO 65806-1131
Phone (417) 851-1551

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidMO

Other names 1

  • Jordan Valley Community Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jordan Valley Community33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

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

View all 32

Practitioners & affiliated clinicians

Practitioners 1

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": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1720566805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E TAMPA ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061131",
            "telephone_number": "417-851-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 LYNN ST",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655363810",
            "telephone_number": "417-344-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCATES FOR A HEALTHY COMMUNITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-01",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "JO",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "417-831-0150"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "MO",
            "license": "2017013552",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jordan Valley Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jordan Valley Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.