NPIMap

Organization Active NPI

Southeast Iowa Regional Medical Center, Inc.

  • Skilled Nursing Facility
  • West Burlington, IA
National Provider Identifier
1265411144
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
290147H Issued in IA
Legal business name
SOUTHEAST IOWA REGIONAL MEDICAL CENTER, INC.
Practice address
1307 S Gear Ave
West Burlington, IA 52655-1604
Phone
(319) 768-4600
NPI assigned
Jan 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Authorized official

Name
Michael McCoy
Title
Ceo
Phone
(319) 768-3268

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X
Skilled Nursing Facility 314000000X 290147H IA Primary

Addresses

Primary practice location

1307 S Gear Ave
West Burlington, IA 52655-1604

Mailing address

1221 S Gear Ave
West Burlington, IA 52655-1679

Other identifiers 2

IdentifierTypeStateIssuer
0651109MedicaidIA
65110OtherIASKILLED UNIT

Other names 3

  • Great River Klein Center Doing business as
  • Klein Center Doing business as
  • Great River Medical Center Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110103000059 IA Part A Provider - Skilled Nursing Facility 3870496417 Practice locations: West Burlington, IA

Skilled nursing facility certification: CCN 165110

Legal name
SOUTHEAST IOWA REGIONAL MEDICAL CENTER INC
Doing business as
KLEIN CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 1, 1977
Last certification
May 1, 2025
Beds
160
Ownership / control type
Other Nonprofit
Organization structure
CorporationNon-profit
Enrollment address
1307 S Gear Ave
West Burlington, IA 52655-1604
Nursing home name
SOUTHEAST IOWA REGIONAL MEDICAL - KLEIN CENTER

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Southeast Iowa Regional Medical - Klein CenterCCN 165110
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
May 1, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
160143.4 residents per day on average
Penalties (3 years)
2Fines totaling $65,094

Processed by Care Compare on Aug 1, 2026.

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
16D0387331Klein Center1307 S Gear Avenue, West Burlington, IA 52655Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Southeast Iowa Regional Med8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 30

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

NameRoleSinceShare
Robert Engberg Individual Corporate Director Jan 1, 2019
Operational/Managerial Control Jan 1, 2019
Michael Yost Individual Operational/Managerial Control Feb 13, 2023
Adp of the SNF Feb 13, 2023
Michael J McCoy Individual Corporate OfficerPresident and Ceo Oct 12, 2022
Corporate Director Nov 16, 2022
Operational/Managerial ControlPresident & Ceo Nov 16, 2022
Michael Hickey Individual Corporate Director Jul 1, 2024
Operational/Managerial Control Jul 1, 2024
Robert Huffman Individual Corporate Director Jan 1, 2022
Operational/Managerial Control Jan 1, 2022
Teresa Colgan Individual Corporate Officer Jul 1, 2021
Operational/Managerial ControlCeo Jul 1, 2021
Cliftonlarsonallen LLP Organization, Minneapolis, MN For-profit Adp of the SNF Jun 14, 2021
Deanna a Barr Individual Corporate Director Mar 1, 2021
Operational/Managerial Control Mar 1, 2021
Jeremy Alexander Individual Operational/Managerial Control Sep 16, 2019
Adp of the SNF Sep 16, 2019
Daniel Linhart Individual Adp of the SNF Jan 1, 2021
Beth Fleming Individual Operational/Managerial ControlVice President-Post Acute Care Mar 20, 2023
Adp of the SNF Mar 20, 2023
Neal Dodd Individual Corporate Director Jan 1, 2022
Operational/Managerial Control Jan 1, 2022
Mary Elise Klopfenstein Individual Operational/Managerial Control Dec 1, 2023
Adp of the SNF Dec 1, 2023
Southeast Iowa Regional Medical Center Inc Organization, West Burlington, IA Corporation, Non-profit Operational/Managerial Control Dec 16, 2010
Adp of the SNF Apr 1, 2013
Russell Rodriguez Individual Operational/Managerial Control Aug 1, 2022
Victoria Stephenson Individual Corporate Director Jan 1, 2022
Operational/Managerial Control Jan 1, 2022
Gina Riherd Individual Corporate DirectorBoard Member Jul 1, 2025
Ryan L Deets Individual Corporate DirectorBoard Member Jan 27, 2026
Operational/Managerial Control Jan 27, 2026
Douglas Martin Individual Corporate Director Jan 1, 2019
Operational/Managerial Control Jan 1, 2019
Hope Dunn Individual Adp of the SNF Jun 27, 2022
John P McKillip Individual Corporate Director Jan 1, 2019
Operational/Managerial Control Jan 1, 2019
Joy Anderson Individual Corporate Director Mar 1, 2021
Operational/Managerial Control Mar 1, 2021
Carla McNamee Individual Corporate Director Mar 1, 2021
Operational/Managerial Control Mar 1, 2021
Tomi Hagan Individual Operational/Managerial Control Dec 3, 2018
Adp of the SNF Dec 3, 2018
Amy West Individual Operational/Managerial Control Aug 26, 2024
Adp of the SNF Aug 26, 2024
John Rashid Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Todd Chelf Individual Operational/Managerial Control Jan 18, 2021
Adp of the SNF Jan 18, 2021
Joel Ryon Individual Operational/Managerial Control Jan 23, 2023
Great River Health System Inc Organization, West Burlington, IA Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Aug 1, 2018 100%
Operational/Managerial Control Aug 1, 2018
Aramark Healthcare Support Services LLC Organization, Philadelphia, PA LLC, For-profit Operational/Managerial Control Feb 23, 2024
Adp of the SNF Feb 19, 2025

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Southeast Iowa Regional Medical Center IncWest Burlington, IA, CCN 160057 Hospital Operational/Managerial Control Jul 1, 1966
Southeast Iowa Regional HospiceWest Burlington, IA, CCN 161567 Hospice 5% Or Greater Direct Ownership Interest (100%) Jul 30, 2001

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1265411144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S GEAR AVE",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 S GEAR AVE",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551604",
            "telephone_number": "319-768-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST IOWA REGIONAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-10",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-768-3268"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "290147H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0651109",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SKILLED UNIT",
            "identifier": "65110",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great River Klein Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Klein Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great River Medical Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in West Burlington, IA

Sources for this page

Verify at the official NPI Registry.