Organization Active NPI

Ottumwa Health Group LLC

Doing business as Ottumwa Women's Health Clinic

  • Rural Health Clinic/Center
  • Ottumwa, IA
National Provider Identifier
1336919364
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
OTTUMWA HEALTH GROUP LLC
Doing business as
Ottumwa Women's Health Clinic
Practice address
931 Pennsylvania Ave
Ottumwa, IA 52501-2138
Phone
(641) 682-8761
Fax
(641) 682-2764
NPI assigned
Jan 2, 2024
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 1

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

Addresses

Primary practice location

931 Pennsylvania Ave
Ottumwa, IA 52501-2138

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Other names 1

  • Ottumwa Women's Health 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
O20100927001257 IA Part B Supplier - Clinic/Group Practice 3971629924 Receives reassigned benefits from 86 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sigourney, IA; Centerville, IA; Ottumwa, IA; Fairfield, IA; Eddyville, IA; Bloomfield, IA
O20240116000348 IA Part A Provider - Rural Health Clinic 3971629924 Practice locations: Ottumwa, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336919364. Details of each certification follow.

Rural health clinic certification: CCN 168986

Legal name
OTTUMWA HEALTH GROUP LLC
Doing business as
OTTUMWA WOMEN'S HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 5, 2025
Last certification
May 5, 2025
Ownership / control type
1B
Organization structure
LLCProprietary
Enrollment address
931 Pennsylvania Ave
Ottumwa, IA 52501-2138

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 5

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
16D0680946Ottumwa Health Group, LLC931 Pennsylvania Avenue, Ottumwa, IA 52501Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Ottumwa Health Group LLC5 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.

Locations

1005 Pennsylvania Ave
Ste 207
Ottumwa, IA 52501
Phone (641) 682-5349

1011 Pennsylvania Ave
Ste D
Ottumwa, IA 52501
Phone (641) 684-2927

1111 N Quincy Ave
Ste 105
Ottumwa, IA 52501
Phone (641) 684-2551

935 Pennsylvania Ave
Ste 100
Ottumwa, IA 52501
Phone (641) 684-3102

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Pamela Kane Individual Corporate OfficerVice President Mar 1, 2026
DSB Acquisition LLC Organization, New York, NY LLC, For-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2024 100%
Laura C Hinson Individual Corporate OfficerChief Financial Officer Mar 12, 2025
Ottumwa Physicians LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2024 100%
Lifepoint Health Inc Organization, Brentwood, TN Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2024 100%
Charlotte E Lawrence Individual Corporate OfficerSecretary Jan 1, 2024
Regionalcare Hospital Partners LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2024 100%
RCHP-Ottumwa Holdings Inc Organization, Brentwood, TN Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2024 100%
Elliott Brown Individual Corporate OfficerSenior Vice President and Treasurer Apr 2, 2026
RCHP LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2024 100%
Klaus Michael Boel Individual Corporate OfficerPresident Aug 19, 2024
W-2 Managing EmployeePresident Aug 19, 2024
Christopher J Monte Individual Corporate OfficerVice President Jan 1, 2024

Facilities with the same owner 19

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

View all 19

Practitioners & affiliated clinicians

Practitioners 84

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.

View all 84

NPI Registry JSON

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1336919364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 PENNSYLVANIA AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012138",
            "telephone_number": "641-682-8761",
            "fax_number": "641-682-2764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTUMWA HEALTH GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ottumwa Women's Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ottumwa, IA

Sources for this page

Verify at the official NPI Registry.