Infinity Health - Archived

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

INFINITY HEALTH - ARCHIVED

Practice address

802 Ackerley St
Lamoni, IA 50140-1544

Phone

(641) 784-7911

Fax

(641) 784-6162

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Samantha Cannon

Title

Ceo

Phone

(641) 446-2383

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Other NPIs on the same Medicare enrollment 9

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

• Infinity Health

  • Federally Qualified Health Center (FQHC)
  • Osceola, IA
  • NPI 1124525647

  O20051024000374

  Same enrollment
• Infinity Health

  • Federally Qualified Health Center (FQHC)
  • Albia, IA
  • NPI 1194941542

  O20051024000374

  Same enrollment
• Infinity Health

  • Federally Qualified Health Center (FQHC)
  • Mount Ayr, IA
  • NPI 1396384657

  O20051024000374

  Same enrollment
• Infinity Health

  • Federally Qualified Health Center (FQHC)
  • Chariton, IA
  • NPI 1568672939

  O20051024000374

  Same enrollment
• Infinity Health

  • Federally Qualified Health Center (FQHC)
  • Corydon, IA
  • NPI 1669697074

  O20051024000374

  Same enrollment
• Infinity Health

  • Federally Qualified Health Center (FQHC)
  • Centerville, IA
  • NPI 1710102132

  O20051024000374

  Same enrollment
• Infinity Health

  • Federally Qualified Health Center (FQHC)
  • Leon, IA
  • NPI 1770521981

  O20051024000374

  Same enrollment
• Infinity Health

  • Federally Qualified Health Center (FQHC)
  • Knoxville, IA
  • NPI 1790364875

  O20051024000374

  Same enrollment
• Infinity Health

  • Federally Qualified Health Center (FQHC)
  • Lamoni, IA
  • NPI 1922294362

  O20051024000374

  Same enrollment

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1083830236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 NE 14TH ST",
            "city": "LEON",
            "state": "IA",
            "postal_code": "501441206",
            "telephone_number": "641-446-2383",
            "fax_number": "641-446-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 ACKERLEY ST",
            "city": "LAMONI",
            "state": "IA",
            "postal_code": "501401544",
            "telephone_number": "641-784-7911",
            "fax_number": "641-784-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITY HEALTH - ARCHIVED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-446-2383"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS/BLUE SHIELD",
            "identifier": "39015",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507202208",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0462861",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK MEDICARE BLUE PPO",
            "identifier": "61827",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Lee Hoffman, DHSC, ATC, LAT
• Dylan Hogan
• Hy-Vee Inc
• Infinity Health
• Infinity Health
• Laney Leigha Jones, MSAT, ATC, LAT
• Lamoni Assisted Living, L.L.C.
• Lamoni C.S.D.
• Lamoni Chiropractic Center, Inc
• Lamoni Family Care Chiropractic LLC

• Federally Qualified Health Center (FQHC) in Lamoni, IA
• Providers in Lamoni, IA by specialty
• Federally Qualified Health Center (FQHC) in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.