NPIMap

Organization Active NPI

Unitypoint Health - Marshalltown

  • Rural Health Clinic/Center
  • Waverly, IA
National Provider Identifier
1124655006
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
UNITYPOINT HEALTH - MARSHALLTOWN
Practice address
312 9TH St SW Ste 1200
Waverly, IA 50677-2998
Phone
(319) 352-4340
NPI assigned
Mar 23, 2020
Organization subpart
Yes
Parent organization
UNITYPOINT HEALTH - MARSHALLTOWNAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
Jennifer Ann Friedly
Title
President
Phone
(641) 754-5145

Specialties & licenses 1

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

Addresses

Primary practice location

312 9TH St SW Ste 1200
Waverly, IA 50677-2998

Mailing address

55 Unitypoint Way
Marshalltown, IA 50158-4749
Phone (641) 754-5145

Other names 1

  • UNITYPOINT CLINIC - FAMILY MEDICINE - ROHLF MEMORIAL Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201208003040 IA Part A Provider - Rural Health Clinic 0941587307 Practice locations: Waverly, IA

Rural health clinic certification: CCN 168650

Legal name
UNITYPOINT HEALTH - MARSHALLTOWN
Doing business as
UNITYPOINT CLINIC - FAMILY MEDICINE - ROHLF MEMORIAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 6, 2020
Last certification
Dec 6, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
312 9TH St SW
Ste 1200
Waverly, IA 50677-2998
Related CCNs
160001

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).

National Provider Directory

National Provider Directory
Tax ID family
Unitypt HLTH - Marshalltown10 organizations share this tax ID, including this one
Part of
Unitypt HLTH - Marshalltown

Other organizations with this tax ID 9

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

Locations

205 N Hartwig St
Conrad, IA 50621
Phone (614) 366-2123

101 E J Ave
Ste 120
Grundy Center, IA 50638
Phone (319) 824-6945

405 E Main St
Fl 1
Marshalltown, IA 50158
Phone (641) 754-5151

51 Unitypoint Way
Ste 130
Marshalltown, IA 50158
Phone (641) 754-5145

405 E Main St
Ofc
Marshalltown, IA 50158
Phone (641) 754-5151

312 9th St SW
Ste 1200
Waverly, IA 50677
Phone (319) 352-0745

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Edita Begic Individual Corporate Director Jan 1, 2024
Todd Holcomb Individual Corporate Director Jan 1, 2026
Bryan Earnest Individual Corporate Director Jan 1, 2024
Joan I Headington Individual Corporate Director Jan 1, 2024
Pradeep M Ramesh Individual Corporate Director Jan 1, 2022
Russell Adams Individual Contracted Managing EmployeeMD; Jan 1, 2018
Operational/Managerial ControlMarket Chief Medical Officer Jan 1, 2018
Shellayne Boldt Individual Contracted Managing EmployeeReg Dir of Primary Care Services Aug 5, 2018
Operational/Managerial ControlReg Dir of Primary Care Services Aug 5, 2018
Jodee a Knox Individual Contracted Managing EmployeeMarket Chief Nursing Office Oct 3, 2023
Operational/Managerial ControlMarket Chief Nursing Office Oct 3, 2023
Julie L Ritland Individual Corporate Director Jan 1, 2026
Marva Zein Individual W-2 Managing EmployeeRHC Clinic Administrator May 8, 2022
Operational/Managerial ControlRHC Clinic Administrator May 8, 2022
Sharon K King Individual W-2 Managing EmployeeHospital Administrator Jun 7, 2020
Operational/Managerial ControlHospital Administrator Jun 7, 2020
Daniel J Darnold Individual Contracted Managing EmployeeMD; Jun 3, 2023
Operational/Managerial ControlRHC Medical Director Jun 3, 2023
Lucas P Lesyshen Individual Corporate Director Jan 1, 2025
Iowa Health System Organization, West Des Moines, IA Corporation, Non-profit Operational/Managerial Control Dec 12, 2016
Allen Health Systems Inc Organization, Waterloo, IA Corporation, Non-profit Operational/Managerial Control Dec 12, 2016
Katherine Susong Individual Corporate Director Jan 1, 2025
Carolyn Barko Individual Contracted Managing EmployeeInterim Market President/RG Amb VP Dec 28, 2025
Corporate OfficerInterim Market President/RG Amb VP Dec 28, 2025
Operational/Managerial ControlInterim Market President/RG Amb VP Dec 28, 2025
Sherry Khurana Individual Contracted Managing EmployeeAssoc Med Dir, Primary Care Service Apr 13, 2017
Operational/Managerial ControlAssoc Med Dir, Primary Care Service Apr 13, 2017
Carol a Hibbs Individual Corporate Director Jan 1, 2023
Daniel G Glascock Individual Contracted Managing EmployeeVice President/Medical Director Aug 12, 2015
Operational/Managerial ControlVice President/Medical Director Aug 12, 2015
Jennifer a Friedly Individual Contracted Managing EmployeeMarket President Jun 12, 2018
Corporate OfficerMarket President Jun 12, 2018
Operational/Managerial ControlMarket President Jun 12, 2018
Natalie Hunter Individual Contracted Managing EmployeeMarket Vice President Operations Jan 14, 2024
W-2 Managing EmployeeMarket Vice President Operations Jan 14, 2014
Zachary H French Individual Contracted Managing EmployeeMarket Vice President of Finance Jan 2, 2022
W-2 Managing EmployeeMarket Vice President of Finance Jan 2, 2022
Operational/Managerial ControlMarket Vice President of Finance Jan 2, 2022

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 69

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

View all 69

Change-of-ownership history 1

DateEventCounterparty
Dec 6, 2020 Change of OwnershipThis provider was the buyer Unitypoint Clinic Family Medicine Rohlf MemorialCCN 168955, IA, NPI 1487699559

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 259

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 259

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1124655006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 UNITYPOINT WAY",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501584749",
            "telephone_number": "641-754-5145",
            "fax_number": "641-844-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 9TH ST SW STE 1200",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772998",
            "telephone_number": "319-352-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITYPOINT HEALTH - MARSHALLTOWN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNITYPOINT HEALTH - MARSHALLTOWN",
        "enumeration_date": "2020-03-23",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "FRIEDLY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "641-754-5145"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UNITYPOINT CLINIC - FAMILY MEDICINE - ROHLF MEMORIAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UNITYPOINT CLINIC - FAMILY MEDICINE - ROHLF MEMORIAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waverly, IA

Sources for this page

Verify at the official NPI Registry.