Virginia Gay Hospital, Inc.

Organization Active NPI Rural Health Clinic/Center · Atkins, IA

NPI 1295099141 · NPPES record last updated Jan 11, 2013

Key facts

NPI
1295099141
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
VIRGINIA GAY HOSPITAL, INC.
Practice address
401 Cardinal Ave
Atkins, IA 52206-4700
Phone
(319) 446-7800
Fax
(319) 446-7814
NPI assigned
Jun 26, 2012
Organization subpart
No

Authorized official

Name
Mr. Michael J Riege
Title
Administrator
Phone
(319) 472-6200

Owners & managing parties with NPI records 8

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

Owned or controlled facilities with NPI records 2

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

Other NPIs on the same Medicare enrollment 3

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

Other NPIs with the same Medicare PAC ID 6

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

Corporate family (same tax ID) 9

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

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

Facilities with the same owner 2

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

Practitioners 26

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

View all 26

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D2045194Atkins Family Medical Clinic
401 Cardinal Avenue, Atkins, IA 52206
Provider-performed microscopyAug 7, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IA

Rural health clinic certification: CCN 168556

Legal name
VIRGINIA GAY HOSPITAL INC
Doing business as
ATKINS FAMILY MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 19, 2013
Last certification
Apr 25, 2016
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Enrollment address
401 Cardinal Ave
Atkins, IA 52206-4700
Related CCNs
161349

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
John F. Yundt
Individual
Corporate Officer
Treasurer
Oct 20, 2009 11%
Corporate Director
Treasurer
Nov 1, 2001 11%
Virginia Gay Hospital Inc
Organization · Vinton, IA
Non-profit
5% Or Greater Direct Ownership Interest Aug 20, 2012 100%
Operational/Managerial Control Aug 20, 2012 100%
John Mossman
Individual
Corporate Officer
Board Member
Jan 1, 2019
David Homer Vermedahl
Individual
Corporate Officer
Secretary
Nov 1, 2004 11%
Corporate Director
Secretary
Nov 1, 2001 11%
Kyle Koeppen
Individual
Corporate Officer
Board Member
Oct 1, 2021
Tina M Eden
Individual
Corporate Officer
Ceo
Apr 1, 2025
W-2 Managing Employee
Ad;Ceo
Apr 1, 2025
Operational/Managerial Control
Ceo
Apr 1, 2025
Sara S Stuefen
Individual
Corporate Director
Board Member
Jan 1, 2019 11%
Michael Jon Riege
Individual
Operational/Managerial Control
Ceo
Jun 15, 1992
Max Maynard
Individual
Corporate Director
Board Member
Jan 1, 2018 11%
Barry W Dietsch
Individual
Corporate Officer
Cfo
Jul 8, 2014
W-2 Managing Employee
Cfo
Jul 8, 2014
Operational/Managerial Control
Cfo
Jul 8, 2014
Brian W Meeker
Individual
Corporate Director
Board Member
Jun 19, 1995 11%
Michelle M Elgin
Individual
Corporate Director
Board Member
Sep 17, 2013 11%
Marie T Foth
Individual
Corporate Director
Board Member
Oct 20, 2009 11%

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Virginia Gay Hospital Home Health
Vinton, IA · CCN 167063
Home health agency Operational/Managerial Control (100%) Dec 15, 1994
Urbana Family Medical Clinic
Urbana, IA · CCN 163485
Rural health clinic Operational/Managerial Control Jun 15, 1992

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040204000919 IA Part B Supplier - Clinic/Group Practice 1759290331 Receives reassigned benefits from 32 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vinton, IA; Atkins, IA
O20121128000728 IA Part a Provider - Rural Health Clinic 1759290331 Practice locations: Atkins, IA

National Provider Directory

Tax ID family
Virginia Gay Hospital (10 organizations share this tax ID)

Locations

401 Cardinal Ave
Atkins, IA 52206
Phone (319) 446-6231

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

401 Cardinal Ave
Atkins, IA 52206-4700

Mailing address

401 Cardinal Ave
Atkins, IA 52206-4700
Phone (319) 446-7800

Other names

  • Atkins Family Medical Clinic Doing business as

Other providers in Atkins, IA

All providers in Atkins, IA · Rural Health Clinic/Center in Iowa

Sources for this page

Verify at the official NPI Registry.