NPIMap

Organization Active NPI

Waverly Health Center

Doing business as Women's Clinic

  • Rural Health Clinic/Center
  • Waverly, IA
National Provider Identifier
1255659124
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WAVERLY HEALTH CENTER
Doing business as
Women's Clinic
Practice address
312 9TH St SW
Suite 2200
Waverly, IA 50677-2909
Phone
(319) 483-4074
Fax
(319) 352-8034
NPI assigned
May 17, 2010
Last updated
Jun 5, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WAVERLY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Authorized official

Name
Ms. Jodi M Geerts
Title
Ceo
Phone
(319) 352-4120

Specialties & licenses 1

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

Addresses

Primary practice location

312 9TH St SW
Suite 2200
Waverly, IA 50677-2909

Mailing address

312 9TH St SW
Waverly, IA 50677-2929
Phone (319) 352-4210

Other names 1

  • Women's Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100708000312 IA Part A Provider - Rural Health Clinic 8820996762 Practice locations: Waverly, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255659124. Details of each certification follow.

Rural health clinic certification: CCN 168540

Legal name
WAVERLY HEALTH CENTER
Doing business as
WOMEN'S CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 28, 2011
Last certification
Sep 22, 2021
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
312 9TH St SW
Suite 2200
Waverly, IA 50677-2909
Related CCNs
161339

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).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D1036453Waverly Heatlh Center Women's Clinic312 Ninth Street SW, Waverly, IA 50677Certificate of waiverApr 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Waverly Health Center12 organizations share this tax ID, including this one
Part of
Waverly Health Center

Other organizations with this tax ID 11

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

Locations

202 Wildcat Way
Janesville, IA 50647
Phone (319) 987-2361

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Stephen L Styron Individual W-2 Managing EmployeeMD; Jan 27, 2023
Operational/Managerial ControlMedical Director Jan 27, 2023
Ann Henninger Trax Individual Corporate Officer Jan 7, 2022
Corporate Director Jan 1, 2020
Jodi M Geerts Individual Corporate OfficerCeo Jan 18, 2023
W-2 Managing EmployeeCeo Jan 18, 2023
Operational/Managerial ControlCeo Jan 18, 2023
Philip S Jones Individual Corporate Officer Jan 7, 2022
Corporate Director Aug 31, 2021
David J Rathe Individual Corporate Director Jan 1, 2024
Laurie Everhardt Individual Corporate Director Jan 1, 2022
Nicole C Myers Individual W-2 Managing EmployeeAd;Chief Clinic Officer May 16, 2023
Operational/Managerial ControlChief Clinic Officer May 16, 2023

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1255659124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 9TH ST SW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772929",
            "telephone_number": "319-352-4210",
            "fax_number": "319-352-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 9TH ST SW",
            "address_2": "SUITE 2200",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772909",
            "telephone_number": "319-483-4074",
            "fax_number": "319-352-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVERLY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAVERLY HEALTH CENTER",
        "enumeration_date": "2010-05-17",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "GEERTS",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-352-4120",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Women's Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waverly, IA

Sources for this page

Verify at the official NPI Registry.