Peoples Community Health Clinic, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

PEOPLES COMMUNITY HEALTH CLINIC, INC

Practice address

118 S Main St
Clarksville, IA 50619-2008

Phone

(319) 278-9020

NPI assigned

Apr 20, 2009

Last updated

Oct 2, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

PEOPLES COMMUNITY HEALTH CLINIC, INC.As reported in NPPES

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

Authorized official

Name

Christine Kemp

Title

Ceo

Phone

(319) 874-3000

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194969238. Details of each certification follow.

• CCN 161852 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 161852

Legal name

PEOPLES COMMUNITY HEALTH CLINIC, INC.

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 5, 2009

Last certification

Mar 5, 2009

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

May 20, 1976 in IA

Enrollment address

118 South Main Street
Clarksville, IA 50619-0310

Other NPIs with the same Medicare PAC ID 2

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

• Peoples Community Health Clinic, Inc

  dba Success Street-West High School

  • Federally Qualified Health Center (FQHC)
  • Waterloo, IA
  • NPI 1629684709

  6406746668

  Same PAC ID
• Peoples Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Waterloo, IA
  • NPI 1093703639

  6406746668

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Peoples Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Waterloo, IA
  • NPI 1093703639

  O20090305000757

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Peoples Community HLTH4 organizations share this tax ID, including this one

Part of

Peoples Community HLTH

Other organizations with this tax ID 3

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

• Peoples Community Health Clinic, Inc

  dba Peoples Clinic Clarksville School

  • Federally Qualified Health Center (FQHC)
  • Clarksville, IA
  • NPI 1336850734
  NPD tax ID
• Peoples Community Health Clinic, Inc.

  dba Peoples Clinic - Traer

  • Federally Qualified Health Center (FQHC)
  • Traer, IA
  • NPI 1215889142
  NPD tax ID
• Peoples Community Health Clinic, Inc.

  dba Peoples Clinic Pharmacy

  • Pharmacy
  • Waterloo, IA
  • NPI 1720108541
  NPD tax ID

All disclosed owners & managing parties 4

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

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538438400000",
    "number": "1194969238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 FRANKLIN ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507034407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 S MAIN ST",
            "city": "CLARKSVILLE",
            "state": "IA",
            "postal_code": "506192008",
            "telephone_number": "319-278-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEOPLES COMMUNITY HEALTH CLINIC, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEOPLES COMMUNITY HEALTH CLINIC, INC.",
        "enumeration_date": "2009-04-20",
        "last_updated": "2018-10-02",
        "status": "A",
        "authorized_official_last_name": "KEMP",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-874-3000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076372",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen B Lopez, RDN
• Holly Meyer, LMFT
• Nashua Family Chiropractic PC (Clarksville Chiropractic)
• Teresa Negen, LPT
• Opportunity Therapy LLC
• Peoples Community Health Clinic, Inc (Peoples Clinic Clarksville School)
• Richard Leroy Pflepsen, D.C.
• Haley Rinken
• Madelyn Schuchmann

• Federally Qualified Health Center (FQHC) in Clarksville, IA
• Providers in Clarksville, 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 Oct 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.