Provider Demographics
NPI:1033530498
Name:COMPASS HEALTH, INC
Entity Type:Organization
Organization Name:COMPASS HEALTH, INC
Other - Org Name:COMPASS HEALTH WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING/CONTRACTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-890-8186
Mailing Address - Street 1:101 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:MO
Mailing Address - Zip Code:64776-9547
Mailing Address - Country:US
Mailing Address - Phone:417-646-8158
Mailing Address - Fax:417-646-8159
Practice Address - Street 1:101 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:MO
Practice Address - Zip Code:64776-9547
Practice Address - Country:US
Practice Address - Phone:844-853-8937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-02
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO793824Medicare Oscar/Certification