NPIMap

Organization Active NPI

Virginia Gay Hospital, Inc.

Doing business as Atkins Family Medical Clinic

  • Rural Health Clinic/Center
  • Atkins, IA
National Provider Identifier
1295099141
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
VIRGINIA GAY HOSPITAL, INC.
Doing business as
Atkins Family Medical Clinic
Practice address
401 Cardinal Ave
Atkins, IA 52206-4700
Phone
(319) 446-7800
Fax
(319) 446-7814
NPI assigned
Jun 26, 2012
Last updated
Jan 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

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 1

  • Atkins Family Medical Clinic Doing business as

Medicare participation

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

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295099141. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
401 Cardinal Ave
Atkins, IA 52206-4700
Related CCNs
161349

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

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 3

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
16D2045194Atkins Family Medical Clinic401 Cardinal Avenue, Atkins, IA 52206Provider-performed microscopyAug 7, 2026

National Provider Directory

National Provider Directory
Tax ID family
Vinton Family Medical C10 organizations share this tax ID, including this one

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 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 OfficerTreasurer Oct 20, 2009 11%
Corporate DirectorTreasurer 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 OfficerBoard Member Jan 1, 2019
David Homer Vermedahl Individual Corporate OfficerSecretary Nov 1, 2004 11%
Corporate DirectorSecretary Nov 1, 2001 11%
Kyle Koeppen Individual Corporate OfficerBoard Member Oct 1, 2021
Tina M Eden Individual Corporate OfficerCeo Apr 1, 2025
W-2 Managing EmployeeAd;Ceo Apr 1, 2025
Operational/Managerial ControlCeo Apr 1, 2025
Sara S Stuefen Individual Corporate DirectorBoard Member Jan 1, 2019 11%
Michael Jon Riege Individual Operational/Managerial ControlCeo Jun 15, 1992
Max Maynard Individual Corporate DirectorBoard Member Jan 1, 2018 11%
Barry W Dietsch Individual Corporate OfficerCfo Jul 8, 2014
W-2 Managing EmployeeCfo Jul 8, 2014
Operational/Managerial ControlCfo Jul 8, 2014
Brian W Meeker Individual Corporate DirectorBoard Member Jun 19, 1995 11%
Michelle M Elgin Individual Corporate DirectorBoard Member Sep 17, 2013 11%
Marie T Foth Individual Corporate DirectorBoard Member Oct 20, 2009 11%

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

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 2

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1340668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1295099141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CARDINAL AVE",
            "city": "ATKINS",
            "state": "IA",
            "postal_code": "522064700",
            "telephone_number": "319-446-7800",
            "fax_number": "319-446-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CARDINAL AVE",
            "city": "ATKINS",
            "state": "IA",
            "postal_code": "522064700",
            "telephone_number": "319-446-7800",
            "fax_number": "319-446-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA GAY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-26",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "RIEGE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "319-472-6200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atkins Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atkins, IA

Sources for this page

Verify at the official NPI Registry.