NPIMap

Organization Active NPI

Alegent Health - Mercy Hospital, Corning, Iowa

Doing business as CHI Health Clinic Lenox

  • Rural Health Clinic/Center
  • Lenox, IA
National Provider Identifier
1285715870
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
873478 Issued in IA
Legal business name
ALEGENT HEALTH - MERCY HOSPITAL, CORNING, IOWA
Doing business as
CHI Health Clinic Lenox
Practice address
210 S Main St
Lenox, IA 50851-1242
Phone
(641) 333-2266
Fax
(641) 333-2231
NPI assigned
Oct 18, 2006
Last updated
Feb 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Evert Kuiper
Title
Ceo - CHI Health
Phone
(402) 343-4420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 873478 IA Primary

Addresses

Primary practice location

210 S Main St
Lenox, IA 50851-1242

Mailing address

210 S Main St
Lenox, IA 50851-1242
Phone (641) 333-2266

Other names 1

  • CHI Health Clinic Lenox Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070530000473 IA Part A Provider - Rural Health Clinic 0547154940 Practice locations: Lenox, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285715870. Details of each certification follow.

Rural health clinic certification: CCN 163478

Legal name
ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA
Doing business as
CHI HEALTH CLINIC LENOX
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 5, 1999
Last certification
Apr 10, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 2, 1953 in IA
Enrollment address
210 S Main St
Lenox, IA 50851-1242
Related CCNs
161304

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

Other NPIs with the same Medicare PAC ID 5

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
16D0384985CHI Health Clinic Lenox210 South Main Street, Lenox, IA 50851Certificate of waiverOct 4, 2026

National Provider Directory

National Provider Directory
Tax ID family
Alegent Health Clinics5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Member of 6

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
CHI Nebraska Organization, Omaha, NE Corporation 5% Or Greater Direct Ownership Interest Aug 1, 2013 100%
Marvin O'Quinn Individual OtherCSH Home Office Administrator Aug 1, 2022
Nadine a Heimann Individual Corporate Director Jul 1, 2019
Maurita Soukup Individual Corporate Director Jul 1, 2017
Commonspirit Health Organization, Englewood, CO Non-profit 5% Or Greater Indirect Ownership Interest Aug 1, 2013 100%
Alicia Reed Individual Operational/Managerial ControlPresident Feb 18, 2022
William Barney Individual Corporate Director Jul 1, 2020
Kevin Fitzgerald Individual Corporate DirectorBod Jul 15, 2021
Suzanne L Hruza Individual Corporate DirectorBoard Member Sep 18, 2014
Nick O'Tool Individual Operational/Managerial ControlInterim Cfo - CHI Health Jan 7, 2023
Heather M Morgan Individual Corporate Director Jul 1, 2020
Kirtibala Gupta Individual Corporate DirectorBod Jul 15, 2021
Evert Kuiper Individual Corporate DirectorCeo CHI Health Jan 17, 2022
Operational/Managerial ControlCeo - CHI Health Jan 17, 2022
John E Petersdorf Individual Corporate Director Jan 21, 2021
William Yates Individual Corporate Director Oct 1, 2015
Mardell Wilson Individual Corporate Director Oct 15, 2020
Kelly Bacon Individual Corporate DirectorBod Jul 15, 2021

Owners & managing parties with NPI records 3

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

Facilities with the same owner 38

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

View all 38

Practitioners & affiliated clinicians

Practitioners 11

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": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1285715870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S MAIN ST",
            "city": "LENOX",
            "state": "IA",
            "postal_code": "508511242",
            "telephone_number": "641-333-2266",
            "fax_number": "641-333-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S MAIN ST",
            "city": "LENOX",
            "state": "IA",
            "postal_code": "508511242",
            "telephone_number": "641-333-2266",
            "fax_number": "641-333-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEGENT HEALTH - MERCY HOSPITAL, CORNING, IOWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "KUIPER",
        "authorized_official_first_name": "EVERT",
        "authorized_official_title_or_position": "CEO - CHI HEALTH",
        "authorized_official_telephone_number": "402-343-4420"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IA",
            "license": "873478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI Health Clinic Lenox",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHI Health Clinic Lenox",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lenox, IA

Sources for this page

Verify at the official NPI Registry.