NPIMap

Organization Active NPI

Compass Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Nevada, MO
National Provider Identifier
1942746052
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMPASS HEALTH, INC.
Practice address
320 Mac Blvd
Nevada, MO 64772-3990
Phone
(660) 890-8186
NPI assigned
Jan 12, 2017
Last updated
Jan 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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

Authorized official

Name
Teresa Porter
Title
Credentialing/Contracting Manager
Phone
(660) 890-8186

Specialties & licenses 1

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

Addresses

Primary practice location

320 Mac Blvd
Nevada, MO 64772-3990

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 890-8186

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170123002168 MO Part A Provider - Federally Qualified Health Center (FQHC) 1951206754 Practice locations: Nevada, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942746052. Details of each certification follow.

Federally qualified health center certification: CCN 261130

Legal name
COMPASS HEALTH INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 23, 2017
Last certification
Jan 23, 2017
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
May 3, 2004 in MO
Enrollment address
320 Mac Blvd
Nevada, MO 64772-3990

National Provider Directory

National Provider Directory
Tax ID family
Pathways Community Behavioral Healthcare Inc127 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Jacob Krafve Individual Corporate DirectorCfo Jan 17, 2017 100%
Teresa L Porter Individual W-2 Managing EmployeeCredentialing & Contracting Manager Jan 17, 2017 100%
Timothy Swinfard Individual Corporate OfficerCeo Jan 17, 2017 100%
Corporate DirectorCeo Jan 17, 2017 100%

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Compass Health IncSaint Peters, MO, CCN 261161 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 11, 2018

NPI Registry JSON

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484265600000",
    "number": "1942746052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-890-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 MAC BLVD",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647723990",
            "telephone_number": "660-890-8186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-13",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "CREDENTIALING/CONTRACTING MANAGER",
        "authorized_official_telephone_number": "660-890-8186"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nevada, MO

Sources for this page

Verify at the official NPI Registry.