Infinity Health
Organization Active NPI Federally Qualified Health Center (FQHC) · Albia, IA
NPI 1194941542 · NPPES record last updated Feb 11, 2022
Key facts
- NPI
- 1194941542
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- INFINITY HEALTH
- Practice address
- 117 S Main St
Albia, IA 52531-2013 - Phone
- (641) 932-2065
- Fax
- (641) 932-2365
- NPI assigned
- Apr 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Samantha Cannon
- Title
- Ceo
- Phone
- (641) 446-2383
Other NPIs on the same Medicare enrollment 9
Other NPIs with the same Medicare PAC ID 11
Practitioners 19
-
Nathan B. Allen, D.O.
-
Elizabeth Marie Brant, ARNP, FNP-C
-
Evelyn Lee Conrad, LMSW
-
Jena Rae Ellerhoff, DNP, ARNP, PMHNP-BC
-
Melissa Groh, LMSW
-
Kylie Kent, LMSW
-
Mackenzie Kirk, PMHNP-BC
-
Regina M Lassabe, LPC, LMHC
-
Sandy Marcus, PMHNP-BC
-
Jordan Marie McCloney, NP-C
-
Danielle Lea O'Brien, M.S., C.R.C.
-
Jennifer Spoerl, ARNP
-
Andrew Sullivan, PA-C
-
Stacy Lynn Tallman, LMSW
-
John Young, LMHC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA
Federally qualified health center certification: CCN 161838
- Legal name
- INFINITY HEALTH
- Doing business as
- BEHAVIORAL HEALTH CENTERS OF SOUTHERN IOWA ALBIA
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 6, 2006
- Last certification
- Dec 6, 2006
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 1, 2005 in IA
- Enrollment address
- 117 S Main St
Albia, IA 52531-2013
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Justin James Akers |
Corporate Director |
Aug 22, 2017 | 10% |
| Rachel Cecil |
Corporate Director | Mar 26, 2019 | 10% |
| Shirley Kessel |
Corporate Director |
Jan 1, 2005 | 10% |
| Jonathan Erb |
Corporate Director | Sep 24, 2019 | 10% |
| Alan Wilson |
Corporate Director | Mar 23, 2010 | 10% |
| William Morain |
Corporate Director |
Jan 1, 2005 | 10% |
| Samantha Cannon |
Corporate Officer |
Nov 27, 2012 | |
| Corporate Director |
Nov 27, 2012 | ||
| W-2 Managing Employee |
Nov 27, 2012 | ||
| Marcy Biesemeyer |
Corporate Director |
Apr 22, 2014 | 10% |
| Dien Judge |
Corporate Director |
Oct 28, 2014 | 10% |
| Linda Baynes |
Corporate Director |
May 22, 2018 | 10% |
| Alan Dykens |
Corporate Director | Jan 24, 2017 | 10% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051024000374 | IA | Part B Supplier - Clinic/Group Practice | 5597717496 |
Receives reassigned benefits from 27 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Albia, IA; Centerville, IA; Chariton, IA; Corydon, IA; Knoxville, IA; Lamoni, IA; Leon, IA; Mount Ayr, IA… |
| O20061012000691 | IA | Part a Provider - Federally Qualified Health Center (FQHC) | 5597717496 |
1 other NPI on this enrollment Practice locations: Albia, IA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | IA | ||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
117 S Main St
Albia, IA 52531-2013
Mailing address
302 NE 14TH St
Leon, IA 50144-1206
Phone (641) 446-2383
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0762708 | Medicaid | IA | |
| 39014 | Other | WELLMARK BLUE CROSS/BLUE SHIELD | |
| 505475103 | Medicaid | MO |
Other providers in Albia, IA
- Heartland Eye Care PLC
- Heritage Creek Dental of Albia LLC
- Kayla Renee Herren
- Homestead of Albia Operations, LLC
- Hy-Vee Inc
- Megan Ann Irving
- Marcy Jones
- Joseph Bates D.D.S
- Tonya Lawrence
- Lynnette M Major
All providers in Albia, IA · Federally Qualified Health Center (FQHC) in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.