Alegent Health Community Memorial Hospital of Missouri Valley, Iowa
Organization Active NPI Rural Health Clinic/Center · Oakland, IA
NPI 1366063794 · NPPES record last updated Feb 10, 2022
Key facts
- NPI
- 1366063794
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA
- Practice address
- 700 S Highway St
Oakland, IA 51560-4357 - Phone
- (712) 482-6484
- NPI assigned
- Apr 27, 2020
- Organization subpart
- No
Authorized official
- Name
- Evert Kuiper
- Title
- Ceo - CHI Health
- Phone
- (402) 343-4420
Owners & managing parties with NPI records 2
-
Kirtibala Gupta, M.D
-
Heather M Morgan, M.D.
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 7
Related certifications (CCN) 1
Facilities with the same owner 38
Practitioners 55
-
Juanita Daisy Alvarez-Hall, MSN, FNP-C
-
Dawn Michelle Bonham, ARNP
-
Sydney Irene Bryen, PA-C
-
Taylor M Ehlert, NP
-
Jane E Gambs, PA-C
-
Alyssa K Hamik, PA-C
-
Brandon Mitchell Jerred, MA, MFT
-
Melissa Kay Klutts, ARNP
-
David A Minnick, MD
-
Sharon Louise Pitt, APRN, FNP-C
-
Tracy A Schoening, ARNP
-
James R Scott, D.O.
-
Ahmad Alchommali, MD
-
Peter F Fowle, LCSW
-
Daniel Edward Hatz, M.D.
-
Christopher Jankovich, P.A.-C.
-
Pamela Lacey Leuschen, APRN, FNP-C
-
Cayce Lynne McMains, CRNA
-
Michael Ryan Zimmerman, D.P.M.
-
Nathaniel Vaughn Alvis, D.O.
-
Melissa Jo Frazier, DNP ARNP
-
Carrie Lynn Grady, M.D.
-
Jennifer Hall, A.R.N.P.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D0385900 | CHI Health Clinic Oakland | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Rural health clinic certification: CCN 168646
- Legal name
- ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IOWA
- Doing business as
- CHI HEALTH CLINIC OAKLAND
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Oct 29, 2020
- Last certification
- Aug 13, 2025
- Ownership / control type
- Non-profit – church related
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 700 S Highway St
Oakland, IA 51560-4357 - Related CCNs
- 161309
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| CHI Nebraska |
5% Or Greater Direct Ownership Interest | Aug 1, 2013 | 100% |
| Commonspirit Health |
5% Or Greater Indirect Ownership Interest | Aug 1, 2013 | 100% |
| David Jones |
Operational/Managerial Control |
Apr 17, 2021 | |
| Cindy a Alloway |
Corporate Director |
Jul 1, 2023 | |
| Tim Bricker |
Corporate Officer |
Jul 1, 2023 | |
| William Barney |
Corporate Director | Jul 1, 2020 | |
| Kevin Fitzgerald |
Corporate Director |
Jul 15, 2021 | |
| Nick O'Tool |
Corporate Officer |
Jan 7, 2023 | |
| Operational/Managerial Control |
Jan 7, 2023 | ||
| Heather M Morgan |
Corporate Director | Jul 1, 2020 | |
| Kirtibala Gupta |
Corporate Director |
Jul 15, 2021 | |
| Evert Kuiper |
Corporate Director |
Jan 17, 2022 | |
| Operational/Managerial Control |
Jan 17, 2022 | ||
| John E Petersdorf |
Corporate Director | Jan 21, 2021 | |
| Mardell Wilson |
Corporate Director | Oct 15, 2020 | |
| Kelly Bacon |
Corporate Director |
Jul 15, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200928002271 | IA | Part a Provider - Rural Health Clinic | 3678482130 | Practice locations: Oakland, IA |
National Provider Directory
- Tax ID family
- Alegent Health Comm Mem
Locations
707 Iowa Ave
Dunlap, IA 51529
Phone (712) 643-2298
704 N 8th St
Mo Valley, IA 51555
Phone (712) 642-2045
410 Ely St
Woodbine, IA 51579
Phone (712) 647-2566
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
700 S Highway St
Oakland, IA 51560-4357
Mailing address
700 S Highway St
Oakland, IA 51560-4357
Other names
- CHI Health Clinic Oakland
Other providers in Oakland, IA
- Anew Healthcare Operations - Oakland Manor, LLC
- Constance L Bridges
- City of Oakland
- Terri S Clark
- Colonial Manors of Oakland, Iowa, Inc.
All providers in Oakland, IA · Rural Health Clinic/Center in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.