NPIMap

Organization Active NPI

Regional Health Services of Howard County

Doing business as Elma Medical Clinic

  • Rural Health Clinic/Center
  • Elma, IA
National Provider Identifier
1104440809
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
REGIONAL HEALTH SERVICES OF HOWARD COUNTY
Doing business as
Elma Medical Clinic
Practice address
600 Busti Ave
Elma, IA 50628-8090
Phone
(000) 000-0000
NPI assigned
May 29, 2020
Last updated
Feb 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Authorized official

Name
Brandon Brevig
Title
Cfo
Phone
(563) 547-6677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

600 Busti Ave
Elma, IA 50628-8090

Mailing address

235 8TH Ave W
Cresco, IA 52136-1062
Phone (563) 547-2101

Other names 1

  • ELMA MEDICAL CLINIC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201020000986 IA Part A Provider - Rural Health Clinic 1153238977 Practice locations: Elma, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104440809. Details of each certification follow.

Rural health clinic certification: CCN 168648

Legal name
REGIONAL HEALTH SERVICES OF HOWARD COUNTY
Doing business as
ELMA MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 11, 2020
Last certification
Sep 30, 2025
Ownership / control type
2B
Organization structure
OtherNon-profit
Enrollment address
600 Busti Ave
Elma, IA 50628-8090
Related CCNs
161328

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 9

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

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
16D2186912Elma Medical Clinic600 Busti Ave, Elma, IA 50628Certificate of waiverJun 22, 2028

National Provider Directory

National Provider Directory
Tax ID family
Regional Health Service12 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.

Locations

402 2nd Ave SE
Cresco, IA 52136
Phone (563) 547-2989

600 Busti Ave
Elma, IA 50628
Phone (641) 393-0058

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Darlene a Vsetecka Individual Corporate DirectorBoard of Trustee Jul 19, 2022
Jeremy C Johnston Individual Corporate DirectorBoard Member Sep 22, 2017
Helen J Kapler Individual Corporate DirectorBoard Member Sep 4, 2012
Charles L Malek Individual Corporate DirectorBoard of Trustee Jul 19, 2022
Howard County Organization, Cresco, IA 5% Or Greater Direct Ownership Interest Sep 1, 2020 100%
Mike W Mahr Individual Corporate DirectorBoard Member Jan 2, 2013
Robin M Schluter Individual Contracted Managing EmployeeCeo Dec 17, 2012
Corporate OfficerCeo Dec 17, 2012
John Wacha Individual Corporate DirectorChair Jan 1, 2011
Brandon T Brevig Individual W-2 Managing EmployeeCfo Feb 9, 2022
Donald J Recker Individual Corporate Director Feb 23, 2015

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Regional Health Services of Howard CountyCresco, IA, CCN 16Z328 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 1974
Lime Springs Medical ClinicLime Springs, IA, CCN 163494 Rural health clinic Operational/Managerial Control Nov 1, 2002
Cresco Medical ClinicCresco, IA, CCN 163493 Rural health clinic Operational/Managerial Control Nov 1, 2002
Leroy Medical ClinicLe Roy, MN, CCN 248504 Rural health clinic Operational/Managerial Control (100%) Sep 1, 1976

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1104440809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 8TH AVE W",
            "city": "CRESCO",
            "state": "IA",
            "postal_code": "521361062",
            "telephone_number": "563-547-2101",
            "fax_number": "563-547-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BUSTI AVE",
            "city": "ELMA",
            "state": "IA",
            "postal_code": "506288090",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL HEALTH SERVICES OF HOWARD COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-29",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "BREVIG",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "563-547-6677"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELMA MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ELMA MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elma, IA

Sources for this page

Verify at the official NPI Registry.