NPIMap

Organization Active NPI

QV Urgent Care Ia, PLLC

  • Rural Health Clinic/Center
  • Newton, IA
National Provider Identifier
1265158950
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
QV URGENT CARE IA, PLLC
Practice address
1817 1St Ave E
Newton, IA 50208-4052
Phone
(641) 658-9008
NPI assigned
Oct 14, 2022
Last updated
Oct 14, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
QUICKVISIT MANAGEMENT IA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Authorized official

Name
Richard Reams Powers Jr., MDNPI 1467428680
Title
Owner
Phone
(931) 540-4210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

1817 1St Ave E
Newton, IA 50208-4052

Mailing address

PO Box 1022
Waynesboro, TN 38485-1022
Phone (931) 722-2369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201120001496 IA Part B Supplier - Clinic/Group Practice 1052722147 Receives reassigned benefits from 78 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Madison, IA; Grinnell, IA; Mt Pleasant, IA; Newton, IA; Osceola, IA; Washington, IA
O20230223001230 IA Part A Provider - Rural Health Clinic 1052722147 Practice locations: Newton, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265158950. Details of each certification follow.

Rural health clinic certification: CCN 168981

Legal name
QV URGENT CARE IA PLLC
Doing business as
QUICKVISIT URGENT CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 31, 2023
Last certification
Jul 31, 2023
Ownership / control type
1B
Organization structure
OtherProprietary
Incorporated
Jul 29, 2019 in IA
Enrollment address
1817 1St Ave E
Newton, IA 50208-4052

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 6

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

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
16D2224777QV Urgent Care Ia PLLC1817 1St Ave E, Newton, IA 50208Certificate of waiverMay 13, 2027

National Provider Directory

National Provider Directory
Tax ID family
Quickvisit Urgent Care6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Stanley Bevis Individual 5% Or Greater Indirect Ownership Interest Jul 29, 2019 9.91%
Corporate DirectorBoard Member Jul 29, 2019
Palmer Family Irrevocable Trust Organization, Laguna Hills, CA 5% Or Greater Indirect Ownership Interest Jul 29, 2019 13.21%
Dustin a Greene Individual Corporate DirectorBoard Member Jul 29, 2019
W-2 Managing EmployeeCeo Jan 1, 2023
Operational/Managerial ControlCeo Jan 1, 2023
Heeschen Revocable Trust Organization, Newport Beach, CA 5% Or Greater Indirect Ownership Interest Jul 29, 2019 6.61%
Quickvisit Management, LLC Organization, Waynesboro, TN LLC 5% Or Greater Indirect Ownership Interest Jul 29, 2019 100%
Quickvisit Management Ia LLC Organization, Waynesboro, TN LLC 5% Or Greater Direct Ownership Interest Jul 29, 2019 100%
Richard Powers Individual 5% Or Greater Indirect Ownership Interest Jul 29, 2019 19.82%
Corporate DirectorBoard Member Jul 29, 2019
Operational/Managerial ControlMedical Director Jul 29, 2019
Greg Palmer Individual Corporate DirectorBoard Member Jul 29, 2019
Gabe Roberts Individual Corporate DirectorBoard Member Jul 29, 2019
Resolute Capital Partners Fund IV LP Organization, Nashville, TN 5% Or Greater Indirect Ownership Interest Jul 29, 2019 10.51%
Bill Nutter Individual Corporate DirectorBoard Member Jul 29, 2019
Evelyn Bevis Individual 5% Or Greater Indirect Ownership InterestVP Support Services Jul 29, 2019 9.91%
Ronald a Malone Individual Corporate DirectorChair of Board Jul 29, 2019

Owners & managing parties with NPI records 2

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

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • QV Urgent Care Ia PLLC

    dba QuickVisit Urgent Care

    • Rural Health Clinic/Center
    • Osceola, IA
    • NPI 1043936735

    Heeschen Revocable Trust, Palmer Family Irrevocable Trust, Quickvisit Management Ia LLC, Quickvisit Management, LLC, Resolute Capital Partners Fund IV LP

    CMS ownership
  • QV Urgent Care Ia PLLC

    dba QuickVisit Urgent Care

    • Rural Health Clinic/Center
    • Grinnell, IA
    • NPI 1053037747

    Heeschen Revocable Trust, Palmer Family Irrevocable Trust, Quickvisit Management Ia LLC, Quickvisit Management, LLC, Resolute Capital Partners Fund IV LP

    CMS ownership
  • QV Urgent Care Ia PLLC

    dba Quickvisit Urgent Care

    • Rural Health Clinic/Center
    • Fort Madison, IA
    • NPI 1114643806

    Heeschen Revocable Trust, Palmer Family Irrevocable Trust, Quickvisit Management Ia LLC, Quickvisit Management, LLC, Resolute Capital Partners Fund IV LP

    CMS ownership
  • QV Urgent Care Ia PLLC

    dba Quickvisit Urgent Care

    • Rural Health Clinic/Center
    • Washington, IA
    • NPI 1235835950

    Heeschen Revocable Trust, Palmer Family Irrevocable Trust, Quickvisit Management Ia LLC, Quickvisit Management, LLC, Resolute Capital Partners Fund IV LP

    CMS ownership
  • QV Urgent Care Ia PLLC

    dba Quickvisit Urgent Care

    • Rural Health Clinic/Center
    • Mt Pleasant, IA
    • NPI 1700502606

    Heeschen Revocable Trust, Palmer Family Irrevocable Trust, Quickvisit Management Ia LLC, Quickvisit Management, LLC, Resolute Capital Partners Fund IV LP

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 2

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": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1265158950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1022",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384851022",
            "telephone_number": "931-722-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 1ST AVE E",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502084052",
            "telephone_number": "641-658-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QV URGENT CARE IA, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUICKVISIT MANAGEMENT IA, LLC",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "POWERS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "REAMS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-540-4210",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, IA

Sources for this page

Verify at the official NPI Registry.