NPIMap

Organization Active NPI

Health Partnership Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Ottawa, KS
National Provider Identifier
1851773709
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEALTH PARTNERSHIP CLINIC, INC
Practice address
107 S Main St
Ottawa, KS 66067-2327
Phone
(913) 648-2266
NPI assigned
Jun 26, 2015
Last updated
Mar 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Authorized official

Name
Amy Falk
Title
Ceo
Phone
(913) 648-2266

Specialties & licenses 1

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

Addresses

Primary practice location

107 S Main St
Ottawa, KS 66067-2327

Mailing address

405 S Clairborne Rd
Suite 2
Olathe, KS 66062-1795
Phone (913) 648-2266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120127000314 KS Part B Supplier - Clinic/Group Practice 6507033867 Receives reassigned benefits from 32 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Olathe, KS; Shawnee Mission, KS; Ottawa, KS; Paola, KS
O20161205001946 KS Part A Provider - Federally Qualified Health Center (FQHC) 6507033867 Practice locations: Ottawa, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851773709. Details of each certification follow.

Federally qualified health center certification: CCN 171871

Legal name
HEALTH PARTNERSHIP CLINIC INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 29, 2016
Last certification
Nov 29, 2016
Ownership / control type
For profit – partnership
Organization structure
OtherNon-profit
Incorporated
Feb 21, 1992 in KS
Enrollment address
107 S Main St
Ottawa, KS 66067-2327

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 4

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

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
17D2175600Health Partnership Clinic107 S Main Street, Ottawa, KS 66067Provider-performed microscopyNov 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Health Partnership Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Kevan Acord Individual Corporate OfficerTreasurer Oct 1, 2017
Bruce Baker Individual Corporate Director Jan 1, 2019
Mina Foster Individual Corporate Director Mar 1, 2019
Mariana Ramirez Individual Corporate DirectorBoard Member Aug 1, 2013
Antonio Booker Individual Corporate Officer Dec 1, 2016
Tracy Price Individual Corporate OfficerSecretary Jan 1, 2016
Tierney L Grasser Individual Corporate OfficerSecretary/Treasurer Jan 22, 2015
Corporate DirectorBoard Member Oct 1, 2006
Shelby Rebeck Individual Corporate DirectorBoard Member Oct 22, 2015
Robin R. Harrold Individual Corporate OfficerChair Jan 24, 2013
Corporate DirectorBoard Member Oct 1, 2009
Wakaba Tessier Individual Corporate Officer Jan 1, 2016
Julia Woods Individual Corporate DirectorBoard Member Oct 22, 2015
Amy Falk Individual Corporate OfficerCeo Mar 21, 2016
W-2 Managing EmployeeCeo Mar 21, 2016

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Health Partnership Clinic IncOlathe, KS, CCN 171845 Federally qualified health center Operational/Managerial Control (100%) Jun 1, 2012
Health Partnership Clinic IncPaola, KS, CCN 171848 Federally qualified health center Operational/Managerial Control (100%) Dec 10, 2012

Owned or controlled facilities with NPI records 2

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

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": "1435276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1851773709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S CLAIRBORNE RD",
            "address_2": "SUITE 2",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621795",
            "telephone_number": "913-648-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S MAIN ST",
            "city": "OTTAWA",
            "state": "KS",
            "postal_code": "660672327",
            "telephone_number": "913-648-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH PARTNERSHIP CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-26",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "FALK",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "913-648-2266"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, KS

Sources for this page

Verify at the official NPI Registry.