Health Partnership Clinic, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Ottawa, KS
NPI 1851773709 · NPPES record last updated Mar 23, 2021
Key facts
- NPI
- 1851773709
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 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
- Organization subpart
- No
Authorized official
- Name
- Amy Falk
- Title
- Ceo
- Phone
- (913) 648-2266
Owned or controlled facilities with NPI records 2
Other NPIs on the same Medicare enrollment 4
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 6
Practitioners 11
-
Thu Thao Thi Le, APRN
-
Eva Clark, WHNP
-
Patricia Elizabeth Fowler, DNP, APRN, FNP-C
-
Noriko Okahara, D.O.
-
Mary Ortiz, LSCSW
-
Jeffrey M Waddell, ARNP, FNP-C
-
Joseph Nichols, ARNP-NP
-
Jazmine Ayana Spencer, MSN, APRN, FNP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D2175600 | Health Partnership Clinic | Provider-performed microscopy | Nov 24, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS
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
- Other · Non-profit
- Incorporated
- Feb 21, 1992 in KS
- Enrollment address
- 107 S Main St
Ottawa, KS 66067-2327
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Kevan Acord |
Corporate Officer |
Oct 1, 2017 | |
| Bruce Baker |
Corporate Director | Jan 1, 2019 | |
| Mina Foster |
Corporate Director | Mar 1, 2019 | |
| Mariana Ramirez |
Corporate Director |
Aug 1, 2013 | |
| Antonio Booker |
Corporate Officer | Dec 1, 2016 | |
| Tracy Price |
Corporate Officer |
Jan 1, 2016 | |
| Tierney L Grasser |
Corporate Officer |
Jan 22, 2015 | |
| Corporate Director |
Oct 1, 2006 | ||
| Shelby Rebeck |
Corporate Director |
Oct 22, 2015 | |
| Robin R. Harrold |
Corporate Officer |
Jan 24, 2013 | |
| Corporate Director |
Oct 1, 2009 | ||
| Wakaba Tessier |
Corporate Officer | Jan 1, 2016 | |
| Julia Woods |
Corporate Director |
Oct 22, 2015 | |
| Amy Falk |
Corporate Officer |
Mar 21, 2016 | |
| W-2 Managing Employee |
Mar 21, 2016 |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Health Partnership Clinic Inc |
Federally qualified health center | Operational/Managerial Control (100%) | Jun 1, 2012 |
| Health Partnership Clinic Inc |
Federally qualified health center | Operational/Managerial Control (100%) | Dec 10, 2012 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Health Partnership Inc
Locations
107 S Main St
Ottawa, KS 66067
Phone (913) 401-2750
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200852450F | Medicaid | KS |
Other providers in Ottawa, KS
- Laura Hardy
- Dana Lynn Harrod
- Samantha Taylor Hart
- Rebecca Hastings
- Tiffinie Hazen
- Heartland Pulmonary & Internal Medicine, PA
- Gwyn F Heidrick
- Linda Mae Herrick
- Michael J Hiatt
- Lesley E Hill
All providers in Ottawa, KS · Federally Qualified Health Center (FQHC) in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.