NPIMap

Organization Active NPI

Advocates for a Healthy Community Inc

Doing business as Jordan Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Buffalo, MO
National Provider Identifier
1750179610
Registry record updated Jun 26, 2025
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
119 N Ash St
Buffalo, MO 65622-8590
Phone
(417) 831-0150
NPI assigned
Apr 29, 2025
Last updated
Jun 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Authorized official

Name
Jessica Hawkins
Title
Credentialing Specialist
Phone
(417) 851-1551

Specialties & licenses 1

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

Addresses

Primary practice location

119 N Ash St
Buffalo, MO 65622-8590

Mailing address

440 E Tampa St
Springfield, MO 65806-1131
Phone (417) 831-0150

Other names 1

  • Jordan Valley Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041109000631 MO Part B Supplier - Clinic/Group Practice 5395653562 Receives reassigned benefits from 198 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lebanon, MO; Springfield, MO; Republic, MO; Buffalo, MO; Hollister, MO; Marshfield, MO
O20250912001688 MO Part A Provider - Federally Qualified Health Center (FQHC) 5395653562 Practice locations: Buffalo, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750179610. Details of each certification follow.

Federally qualified health center certification: CCN 791918

Legal name
ADVOCATES FOR A HEALTHY COMMUNITY INC
Doing business as
JORDAN VALLEY COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 12, 2025
Last certification
Sep 12, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
119 N Ash St
Buffalo, MO 65622-8590

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

590 Birch Rd
Ste 2B
Hollister, MO 65672
Phone (417) 334-7277

290 E Central St
Springfield, MO 65802

3000 E Division St
Springfield, MO 65802
Phone (417) 869-8000

618 N Benton Ave
Springfield, MO 65806
Phone 41785115511015

Ownership & related parties

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
Amy Poe Individual Corporate OfficerVice Chair Jun 1, 2025
Nicholas Pfannenstiel Individual W-2 Managing EmployeeCoo/Evp Dec 1, 2024
Jeff Davis Individual Corporate OfficerMember Dec 1, 2024
Mendie Schoeller Individual Corporate OfficerMember-at-Large Jun 1, 2025
Matthew Stinson Individual Corporate DirectorCeo/President Dec 1, 2025
Operational/Managerial ControlCeo/President Dec 1, 2024
Trey Peck Individual Corporate OfficerChair Jun 1, 2025
Kevin Gipson Individual Corporate OfficerMember-at-Large Dec 1, 2024
Phil Brown Individual Corporate OfficerTreasure Dec 1, 2024
Carol Dehaven Janick Individual Corporate OfficerMember Jun 1, 2025
Mike Schnake Individual Corporate OfficerMember Dec 1, 2024

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 211

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.

View all 211

NPI Registry JSON

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

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1750179610",
    "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": "417-831-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N ASH ST",
            "city": "BUFFALO",
            "state": "MO",
            "postal_code": "656228590",
            "telephone_number": "417-831-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCATES FOR A HEALTHY COMMUNITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "417-851-1551"
    },
    "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": "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 Buffalo, MO

Sources for this page

Verify at the official NPI Registry.