NPIMap

Organization Active NPI

Greater Sioux Community Health Center Inc.

Doing business as Promise Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Sioux Center, IA
National Provider Identifier
1053582098
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GREATER SIOUX COMMUNITY HEALTH CENTER INC.
Doing business as
Promise Community Health Center
Practice address
33 4TH St NW
Sioux Center, IA 51250-1870
Phone
(712) 722-1700
Fax
(712) 722-1770
NPI assigned
Mar 18, 2008
Last updated
Aug 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Authorized official

Name
Emily Tuschen
Title
Ceo
Phone
(712) 722-1700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

33 4TH St NW
Sioux Center, IA 51250-1870

Mailing address

33 4TH St NW
Sioux Center, IA 51250-1870
Phone (712) 722-1700

Other names 1

  • Promise Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080717000707 IA Part B Supplier - Clinic/Group Practice 3173696572 Receives reassigned benefits from 15 practitioners
7 other NPIs on this enrollment
Practice locations: Sioux Center, IA; Rock Valley, IA; Ireton, IA; Hawarden, IA
O20100201000163 IA Part A Provider - Federally Qualified Health Center (FQHC) 3173696572 Practice locations: Sioux Center, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053582098. Details of each certification follow.

Federally qualified health center certification: CCN 161853

Legal name
GREATER SIOUX COMMUNITY HEALTH CENTER INC
Doing business as
PROMISE COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 15, 2010
Last certification
Mar 15, 2010
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Nov 29, 2006 in IA
Enrollment address
33 4TH St NW
Sioux Center, IA 51250-1870

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D1082351Greater Sioux Community Health Center, Inc33 4TH St NW, Sioux Center, IA 51250Certificate of waiverApr 6, 2028

National Provider Directory

National Provider Directory
Tax ID family
Greater Sioux Center Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

1712 20th Ave
Rm 406
Rock Valley, IA 51247
Phone (712) 722-1700

338 1st Ave NW
Sioux Center, IA 51250
Phone (712) 722-1700

397 10th St SE
Rm 1113
Sioux Center, IA 51250
Phone (712) 722-1700

950 4th Ave NE
Rm 2121
Sioux Center, IA 51250
Phone (712) 722-1700

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Don Ortman Individual Corporate DirectorBoard Member Jul 1, 2008
Judith Hauswald Individual Corporate Director Dec 15, 2009
Eric Dooyema Individual Corporate DirectorBoard Member Sep 30, 2011
Duane Ver Mulm Individual Corporate DirectorBoard Member Oct 15, 2013
Evan de Groot Individual Corporate DirectorBoard Member Oct 10, 2010
Amy McAlpine Individual Corporate OfficerCoo Aug 15, 2022
Emily Tuschen Individual Corporate OfficerCeo Dec 1, 2018 100%
Corporate DirectorCeo Dec 1, 2018 100%
W-2 Managing EmployeeCeo Dec 1, 2018 100%
Cindy Harpenau Individual Corporate DirectorBoard Member Jul 1, 2008
Mark Juhl Individual Corporate DirectorBoard Member Sep 28, 2005

Subparts reporting this organization as parent 7

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1053582098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 4TH ST NW",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512501870",
            "telephone_number": "712-722-1700",
            "fax_number": "712-722-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 4TH ST NW",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512501870",
            "telephone_number": "712-722-1700",
            "fax_number": "712-722-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER SIOUX COMMUNITY HEALTH CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "TUSCHEN",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "712-722-1700"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Promise Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux Center, IA

Sources for this page

Verify at the official NPI Registry.