NPIMap

Organization Active NPI

Unitypoint Health - Marshalltown

  • Rural Health Clinic/Center
  • Grundy Center, IA
National Provider Identifier
1255977740
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
101 E J Ave Ste 120
Grundy Center, IA 50638-2006
Phone
(319) 824-6945
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

101 E J Ave Ste 120
Grundy Center, IA 50638-2006

Mailing address

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

Other names 1

  • UNITYPOINT CLINIC - FAMILY MEDICINE - GRUNDY CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200205000285 IA Part A Provider - Rural Health Clinic 0941587307 Practice locations: Grundy Center, IA

Rural health clinic certification: CCN 168634

Legal name
UNITYPOINT HEALTH - MARSHALLTOWN
Doing business as
UNITYPOINT CLINIC - FAMILY MEDICINE - GRUNDY CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 22, 2019
Last certification
Jan 11, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
101 E J Ave
Ste 120
Grundy Center, IA 50638-2006
Related CCNs
160001

Facilities connected through Provider of Services related, parent or unit certification numbers.

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
Todd Holcomb Individual Corporate Director Jan 1, 2026
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
Pradeep M Ramesh Individual Corporate Director Jan 1, 2022
Russell Adams Individual Contracted Managing EmployeeMD; 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
Emily Dahle Individual W-2 Managing EmployeeClinic Administrator Oct 20, 2022
Operational/Managerial ControlClinic Administrator Oct 20, 2022
Julie L Ritland Individual Corporate Director Jan 1, 2026
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, Chain home office Operational/Managerial Control Dec 12, 2016
Allen Health Systems Inc Organization, Waterloo, IA Corporation, Non-profit Operational/Managerial Control Dec 12, 2016
Katherine Susong Individual Corporate Director Jan 1, 2025
Carolyn Barko Individual Contracted Managing EmployeeInterim Marketpresident/RG Ambvp Dec 28, 2025
Corporate OfficerInterim Marketpresident/RG Ambvp Dec 28, 2025
Operational/Managerial ControlInterim Marketpresident/RG Ambvp Dec 28, 2025
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
Carol a Hibbs Individual Corporate Director Jan 1, 2023
Samantha M Bissen Individual Contracted Managing EmployeeMD; Jan 2, 2026
Operational/Managerial ControlRHC Medical Director Jan 2, 2026
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 W-2 Managing Employee Jan 14, 2024
Zachary H French Individual W-2 Managing EmployeeMarket Vice President Finance Jan 2, 2022

Owners & managing parties with NPI records 5

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 Grundy CenterCCN 168953, IA, NPI 1013952183

Change of ownership 1

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

Other NPIs with the same Medicare PAC ID 9

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

Practitioners 26

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

View all 26

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": "1255977740",
    "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": "101 E J AVE STE 120",
            "city": "GRUNDY CENTER",
            "state": "IA",
            "postal_code": "506382006",
            "telephone_number": "319-824-6945"
        }
    ],
    "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 - GRUNDY CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UNITYPOINT CLINIC - FAMILY MEDICINE - GRUNDY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grundy Center, IA

Sources for this page

Verify at the official NPI Registry.