NORTHWEST HEALTH SERVICES, INC (NPI# 1194846550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194846550 |
| Entity Type | Organization |
| Organization Name | NORTHWEST HEALTH SERVICES, INC |
| Other Organization Name | SOUTH SIDE HEALTH CENTER |
| Practice Address |
5001 Lake Ave Saint Joseph MO 64504-1170 |
| Practice Telephone | 8162387788 |
| Practice Fax Number | 8162389285 |
| Mailing Telephone | 8162387788 |
| Mailing Fax Number | 8162389285 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2018-09-20 |
| Authorized Official Name | BENJAMIN D. ERNST (CEO) |
| Authorized Official Telephone | 8162718262 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 509384202 | 05 |
| Other Name | Type Code |
|---|---|
| South Side Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407360449 | Northwest Health Services, Inc | Family Medicine | 303 South Us Hwy 169, Gower, MO 64454 | 2017-11-29 |
| 1437270915 | Northwest Health Services, Inc | Family Medicine | 1303 State Street, Mound City, MO 64470-1717 | 2007-04-03 |
| 1104947126 | Northwest Health Services, Inc | Family Medicine | 803 Highway 71 West, Savannah, MO 64485 | 2007-04-03 |
| 1588294151 | Northwest Health Services, Inc | Clinic/Center | 1503 S Munn Ave, Maryville, MO 64468-2757 | 2020-01-22 |
| 1629190822 | Northwest Health Services, Inc | Family Medicine | 2303 Village Dr, Saint Joseph, MO 64506-4954 | 2007-04-06 |
| 1053433920 | Northwest Health Services, Inc | Family Medicine | 707 Victory Lane, Cainsville, MO 64632 | 2007-04-04 |
| 1790806842 | Northwest Health Services, Inc | Family Medicine | 305 Rhode Island, King City, MO 64463 | 2007-04-03 |
| 1215059209 | Northwest Health Services, Inc | Family Medicine | 109 Main Street, Braymer, MO 64624 | 2007-04-03 |
| 1396866737 | Northwest Health Services, Inc | Family Medicine | 1515 Saint Joseph Ave, Saint Joseph, MO 64505-2631 | 2007-04-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHWEST HEALTH SERVICES, INC. | 2303 Village Dr, Saint Joseph, MO 64506-4954 |
| Street Address |
5001 LAKE AVE |
| City | SAINT JOSEPH |
| State | MO |
| Zip Code | 64504-1170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477521995 | Deborah A Weems | Emergency Medicine | 5001 Lake Ave, Saint Joseph, MO 64504 | 2006-03-10 |
| 1548821184 | Kweku Osei | Nurse Practitioner | 5001 Lake Ave, Saint Joseph, MO 64504-1170 | 2019-06-25 |
| 1538655535 | Tiffani L Bradbury | Nurse Practitioner | 5001 Lake Ave, Saint Joseph, MO 64504-1170 | 2018-07-03 |
| 1891201869 | Nathan Eugene Noakes | Social Worker | 5001 Lake Ave, Saint Joseph, MO 64504-1170 | 2017-12-28 |
| 1992215271 | Kelly D Adkins | Social Worker | 5001 Lake Ave, Saint Joseph, MO 64504-1170 | 2017-10-02 |
| 1790294007 | Christian Dale Tanner | Nurse Practitioner | 5001 Lake Ave, Saint Joseph, MO 64504-1170 | 2017-09-29 |
| 1134662901 | Brittany Shea Mace | Nurse Practitioner | 5001 Lake Ave, Saint Joseph, MO 64504-1170 | 2016-11-29 |
| 1669928024 | Carissa Janel Crabb | Social Worker | 5001 Lake Ave, Saint Joseph, MO 64504-1170 | 2016-08-26 |
| 1790942910 | Cristyn Watkins | Family Medicine | 5001 Lake Ave, Saint Joseph, Saint Joseph, MO 64504-1170 | 2008-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427151695 | David Cathcart | Family Medicine | 401 Illinois, Saint Joseph, MO 64504 | 2006-09-06 |
| 1912988270 | Wrinkle's Pharmacy, Inc. | Pharmacy | 5409 Lake Ave, Saint Joseph, MO 64504-1439 | 2005-11-12 |
| 1053502609 | Melissa A Glenski | Pharmacist | 5409 Lake Ave, Saint Joseph, MO 64504-1439 | 2007-08-08 |
| 1285676197 | Robert Grimm | Chiropractor | 5505 Lake Ave, Saint Joseph, MO 64504-1440 | 2006-06-12 |
| 1447314919 | Grimm Chiropractic PC | Chiropractor | 5505 Lake Ave, Saint Joseph, MO 64504-1440 | 2006-12-20 |
| 1437504594 | Jenna Beth Zettel | Specialist/Technologist | 5655 S 4th St, Saint Joseph, MO 64504-1708 | 2016-04-26 |
| 1417465600 | Kaci Ludwig | Specialist/Technologist | 5655 S 4th St, Saint Joseph, MO 64504-1708 | 2018-01-22 |
| 1952349367 | Stevenson Family Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 6201 King Hill Ave, Saint Joseph, MO 64504-2063 | 2006-06-04 |
| 1629474408 | Jonathan Douglas Kountz | Pharmacist | 6201 King Hill Ave, Saint Joseph, MO 64504-2063 | 2014-11-06 |
| 1821295437 | Tender Care Inc. | Home Health | 6804 Ollmeda St, Saint Joseph, MO 64504-2632 | 2007-06-27 |
| Find all providers in zip 64504 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477037653 | Tensas Community Health Center Inc | Clinic/Center | 720 Plank Rd Rm 25, Saint Joseph, LA 71366-6616 | 2018-09-24 |
| 1861904179 | Tensas Community Health Center Inc | Clinic/Center | 916 Plank Road, Saint Joseph, LA 71366 | 2017-10-26 |
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|---|---|---|---|---|
| 1952909079 | Northwest Health Services Inc | Clinic/Center | 202 S East St, Albany, MO 64402-1836 | 2020-10-12 |
| 1912505041 | Northwest Health Services Inc | Clinic/Center | 10500 State Route T, Savannah, MO 64485-2456 | 2020-10-12 |
| 1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
| 1407478399 | Big Springs Medical Association | Clinic/Center | 2879 James Blvd, Poplar Bluff, MO 63901-3395 | 2020-05-13 |
| 1295356731 | Health Care Coalition of Lafayette County | Clinic/Center | 811 S Business Highway 13, Lexington, MO 64067-1515 | 2020-05-06 |
| 1376164699 | East Central Missouri Behavioral Health Services, Inc | Clinic/Center | 896 S Sturgeon St, Montgomery City, MO 63361-2716 | 2020-04-27 |
| 1750912044 | Northwest Health Services, Inc. | Clinic/Center | 418 E 2nd St, Maryville, MO 64468-1703 | 2020-01-27 |
| 1669003950 | Northwest Health Services, Inc. | Clinic/Center | 525 W South Hills Dr, Maryville, MO 64468-3653 | 2020-01-27 |
| 1063052553 | Compass Health, Inc. | Clinic/Center | 1319 E Highway 24 Ste B, Moberly, MO 65270-3682 | 2020-01-13 |
| 1407490741 | Advocates for A Healthy Community Inc | Clinic/Center | 2238 W Kingsley St, Springfield, MO 65807-5456 | 2019-10-30 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOSEPH |
| Zip Code | 64504 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.