Provider Demographics
NPI:1174047658
Name:COMPASS COMMUNITY HEALTH
Entity type:Organization
Organization Name:COMPASS COMMUNITY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUMMER
Authorized Official - Middle Name:M
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-355-7102
Mailing Address - Street 1:1634 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-4526
Mailing Address - Country:US
Mailing Address - Phone:740-355-7102
Mailing Address - Fax:740-353-3083
Practice Address - Street 1:1656 COLES BLVD STE A
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2632
Practice Address - Country:US
Practice Address - Phone:740-355-7102
Practice Address - Fax:740-876-8863
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPASS COMMUNITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-27
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH249180Medicaid