NPIMap

Organization Active NPI

Capstone Health

Doing business as Capstone Viking Health

  • Federally Qualified Health Center (FQHC)
  • Jasper, AL
National Provider Identifier
1770156077
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CAPSTONE HEALTH
Doing business as
Capstone Viking Health
Practice address
1501 Viking Dr
Jasper, AL 35501-4942
Phone
(205) 686-5113
NPI assigned
Jul 23, 2021
Last updated
Aug 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Authorized official

Name
Foster David Jones, CRNPNPI 1093764888
Title
Executive Director
Phone
(205) 686-5113

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

1501 Viking Dr
Jasper, AL 35501-4942

Mailing address

PO Box 169
Parrish, AL 35580-0169

Other names 1

  • Capstone Viking Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220128000548 AL Part A Provider - Federally Qualified Health Center (FQHC) 7719990316 Practice locations: Jasper, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770156077. Details of each certification follow.

Federally qualified health center certification: CCN 011092

Legal name
CAPSTONE HEALTH
Doing business as
CAPSTONE VIKING HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 3, 2022
Last certification
Jan 3, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 18, 2005 in AL
Enrollment address
1501 Viking Dr
Jasper, AL 35501-4942

Other NPIs with the same Medicare PAC ID 4

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

  • Capstone Health

    dba Capstone Double Springs

    • Federally Qualified Health Center (FQHC)
    • Double Springs, AL
    • NPI 1508405069

    7719990316

    Same PAC ID
  • Capstone Health

    dba Capstone West Jasper

    • Federally Qualified Health Center (FQHC)
    • Jasper, AL
    • NPI 1528670452

    7719990316

    Same PAC ID
  • Capstone Health

    dba Capstone Cottage

    • Federally Qualified Health Center (FQHC)
    • Parrish, AL
    • NPI 1821043837

    7719990316

    Same PAC ID
  • Capstone Health

    dba Hilltop Health

    • Federally Qualified Health Center (FQHC)
    • Carbon Hill, AL
    • NPI 1871365569

    7719990316

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
The Capstone Rural Health Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

1501 Viking Dr
Jasper, AL 35501
Phone (205) 724-9028

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Lindsey Jones Individual Corporate Director Aug 31, 2017
Lamar D. Lawrence Individual Corporate Director Jul 16, 2015
Carol C. Downs Individual Corporate Director Aug 20, 2015
Cynthia Bryant Individual Corporate Director May 21, 2020
Shelley Jones Individual Corporate Director Sep 19, 2019
Jerry Callahan Individual Corporate DirectorVice Chair Sep 22, 2011
Foster D Jones Individual Corporate DirectorExecutive Director Jul 1, 2012
W-2 Managing Employee Oct 24, 2011
Mary Sanders Individual Corporate Director Sep 18, 2018
Dale Reed Cottle Individual Corporate Director Jan 22, 2018
Amber Elswick Individual Corporate Director Aug 31, 2017
June Kinley Individual Corporate Director Sep 26, 2013
Ann Graves Individual Corporate Director Feb 19, 2019
Wayne Spainhoward Individual Corporate Director Oct 2, 2017
James Brakefield Individual Corporate DirectorChair Mar 24, 2011
William Doss Individual Corporate Director Aug 20, 2015

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Capstone CottageJasper, AL, CCN 011026 Federally qualified health center Operational/Managerial Control Aug 18, 2005

Owned or controlled facilities with NPI records 1

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

  • Capstone Health

    dba Capstone Cottage

    • Federally Qualified Health Center (FQHC)
    • Parrish, AL
    • NPI 1821043837

    Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 2

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": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1770156077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 169",
            "city": "PARRISH",
            "state": "AL",
            "postal_code": "355800169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 VIKING DR",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355014942",
            "telephone_number": "205-686-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPSTONE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "FOSTER",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "205-686-5113",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capstone Viking Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Capstone Viking Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jasper, AL

Sources for this page

Verify at the official NPI Registry.