NPIMap

Organization Active NPI

Primary Health Care, Inc.

Doing business as Primary Health Care-Marshalltown Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Marshalltown, IA
National Provider Identifier
1003293317
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PRIMARY HEALTH CARE, INC.
Doing business as
Primary Health Care-Marshalltown Dental Clinic
Practice address
101 Iowa Ave W
Ste 102
Marshalltown, IA 50158-4768
Phone
(641) 753-4021
Fax
(515) 644-6792
NPI assigned
May 6, 2015
Last updated
Jan 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Authorized official

Name
Nathaniel A Simpson
Title
Chief Executive Officer
Phone
(515) 248-1441

Specialties & licenses 1

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

Addresses

Primary practice location

101 Iowa Ave W
Ste 102
Marshalltown, IA 50158-4768

Mailing address

1200 University Ave Ste 200
Des Moines, IA 50314-2355
Phone (515) 248-1447

Other names 1

  • Primary Health Care-Marshalltown Dental Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150610002679 IA Part A Provider - Federally Qualified Health Center (FQHC) 8426966755 Practice locations: Marshalltown, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003293317. Details of each certification follow.

Federally qualified health center certification: CCN 161864

Legal name
PRIMARY HEALTH CARE INC
Doing business as
PRIMARY HEALTH CARE-MARSHALLTOWN DENTAL CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 10, 2015
Last certification
Jun 10, 2015
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Dec 13, 1989 in IA
Enrollment address
101 Iowa Ave W
Ste 102
Marshalltown, IA 50158-4781

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Primary Health Care13 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Billie Wade Individual Corporate Director May 1, 2012
Janet L Hicks Individual Corporate Director Jan 26, 2018
Sandra Hansen Individual Corporate Director Oct 1, 2014
Alicia Luisa Medici Huguelet Individual Corporate Director Jan 27, 2023
Roger Alan Lacoy Individual Corporate Director Oct 30, 2015
Maryna N Salas Individual Corporate Director Jan 27, 2023
Scott Clair Individual Corporate Director Apr 26, 2013
Juan Cadenillas Individual Corporate Director Jul 1, 2008
William Schoenenberger Individual Corporate Director Jul 1, 2008
Benjamin E Bellus Individual Corporate Director Jul 1, 1998
Sergio Hernandez Individual Corporate Director Jul 1, 2007
Denise Essman Individual Corporate Director Aug 31, 2018
Karin Jean Derry Individual Corporate Director May 27, 2016
Jennifer Lynne Nobisch Individual Corporate Director Jun 1, 2021
Megan K Frost Individual Corporate DirectorClinic Administrator Dec 27, 2016
Ted Morris Johnson Individual Corporate Director May 27, 2016
Kelly a Huntsman Individual Corporate DirectorChief Executive Director Apr 29, 2002
W-2 Managing EmployeeChief Executive Director Apr 29, 2002
Elizabeth Irene Frantum Individual Corporate DirectorChief Financial Officer Oct 31, 2022

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767744000000",
    "number": "1003293317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 UNIVERSITY AVE STE 200",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142355",
            "telephone_number": "515-248-1447",
            "fax_number": "515-248-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 IOWA AVE W",
            "address_2": "STE 102",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501584768",
            "telephone_number": "641-753-4021",
            "fax_number": "515-644-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-06",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "515-248-1441"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Health Care-Marshalltown Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Primary Health Care-Marshalltown Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marshalltown, IA

Sources for this page

Verify at the official NPI Registry.