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

1505 Logan Ave
Waterloo, IA 50703-1910

Phone

(319) 433-2500

NPI assigned

Oct 25, 2021

Organization subpart

Yes

Parent organization

PEOPLES COMMUNITY HEALTH CLINIC, INCAs reported in NPPES

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

Authorized official

Name

Beth White

Title

HR Administrator

Phone

(319) 874-3000

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Success Street - Carver Academy Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

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

• Peoples Community Health Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Clarksville, IA
  • NPI 1336850734

  O20040319000493

  Same enrollment
• Peoples Community Health Clinic, Inc

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

  O20040319000493

  Same enrollment
• Peoples Community Health Clinic, Inc

  • Federally Qualified Health Center (FQHC)
  • Waterloo, IA
  • NPI 1952917049

  O20040319000493

  Same enrollment
• Peoples Community Health Clinic, Inc.

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

  O20040319000493

  Same enrollment
• Peoples Community Health Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Traer, IA
  • NPI 1215889142

  O20040319000493

  Same enrollment

Part of

Peoples Clinic Pharmacy

Locations

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1255095477",
    "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",
            "telephone_number": "319-874-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031910",
            "telephone_number": "319-433-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEOPLES COMMUNITY HEALTH CLINIC, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEOPLES COMMUNITY HEALTH CLINIC, INC",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-06",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "HR ADMINISTRATOR",
        "authorized_official_telephone_number": "319-874-3000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS AND BLUE SHIELD",
            "identifier": "15689",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076372",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@peoples-clinic.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1505 Logan Ave",
            "city": "Waterloo",
            "state": "IA",
            "country_code": "US",
            "postal_code": "507031910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Success Street - Carver Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laval A Peloquin, MD
• Katy Pelzer, DH
• Noemy Penafiel
• Tarah Michelle Penning, PHARMD
• Laura F. Penrith, MPT
• Peoples Community Health Clinic, Inc
• Peoples Community Health Clinic, Inc
• Peoples Community Health Clinic, Inc.
• Peoples Community Health Clinic, Inc.
• Michael F. Peters, M.D.

• Federally Qualified Health Center (FQHC) in Waterloo, IA
• Providers in Waterloo, 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 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.