NPIMap

Organization Active NPI

Unitypoint Health - Marshalltown

  • Rural Health Clinic/Center
  • Parkersburg, IA
National Provider Identifier
1164068656
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
502 3Rd St
Parkersburg, IA 50665-2063
Phone
(319) 346-2331
NPI assigned
Nov 20, 2019
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

502 3Rd St
Parkersburg, IA 50665-2063

Mailing address

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

Other names 1

  • UNITYPOINT CLINIC - FAMILY MEDICINE - PARKERSBURG Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200121000684 IA Part A Provider - Rural Health Clinic 0941587307 Practice locations: Parkersburg, IA

Rural health clinic certification: CCN 168635

Legal name
UNITYPOINT HEALTH - MARSHALLTOWN
Doing business as
UNITYPOINT CLINIC - FAMILY MEDICINE - PARKERSBURG
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 22, 2019
Last certification
Sep 8, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
502 3Rd St
Parkersburg, IA 50665-2063
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.

Ownership & related parties

All disclosed owners & managing parties 24

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 Feb 1, 2024
Kalyana Sundaram Individual Corporate Director Jan 1, 2020
Lance Horbach Individual Corporate Officer Jan 1, 2020
Corporate Director May 1, 2017
Bryan Earnest Individual Corporate Director Jun 1, 2017
Joan I Headington Individual Corporate Director Jan 1, 2020
William E Durbin Individual Contracted Managing EmployeeMedical Director Dec 22, 2019
Operational/Managerial ControlMedical Director Dec 22, 2019
Pradeep M Ramesh Individual Corporate Director Jan 1, 2022
Russell Adams Individual Contracted Managing EmployeeChief 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
Sharon K King Individual W-2 Managing EmployeeHospital Administrator Jun 7, 2020
Operational/Managerial ControlHospital Administrator Jun 7, 2020
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
Stacey Bentley Individual Corporate Officer Jan 1, 2020
Corporate Director Jan 1, 2020
Allen Health Systems Inc Organization, Waterloo, IA Corporation, Non-profit Operational/Managerial Control Dec 12, 2016
Katherine Susong Individual Corporate Officer Jan 1, 2025
Shannon M Roder Individual W-2 Managing EmployeeClinic Administrator Dec 22, 2019
Operational/Managerial ControlClinic Administrator Dec 22, 2019
Carolyn Barko Individual Contracted Managing EmployeeRegional Ambulatory Vice President Jan 18, 2022
Operational/Managerial ControlRegional Ambulatory Vice President Jan 18, 2022
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
Kyle P Christiason Individual Corporate Officer Jan 1, 2022
Corporate Director Jan 1, 2020
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 EmployeeVice President of Operations Jan 14, 2024
Zachary H French Individual W-2 Managing EmployeeMarket Vice President Finance Jan 2, 2022

Owners & managing parties with NPI records 6

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 22, 2019 Change of OwnershipThis provider was the buyer Unitypoint Clinic Family Medicine ParkersburgCCN 168903, IA, NPI 1811945587

Change of ownership 1

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

Practitioners & affiliated clinicians

Practitioners 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1164068656",
    "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": "502 3RD ST",
            "city": "PARKERSBURG",
            "state": "IA",
            "postal_code": "506652063",
            "telephone_number": "319-346-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITYPOINT HEALTH - MARSHALLTOWN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNITYPOINT HEALTH - MARSHALLTOWN",
        "enumeration_date": "2019-11-20",
        "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 - PARKERSBURG",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UNITYPOINT CLINIC - FAMILY MEDICINE - PARKERSBURG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parkersburg, IA

Sources for this page

Verify at the official NPI Registry.