NPIMap

Organization Active NPI

Henry County Health Center, Inc.

Doing business as Henry County Health Center-Wapello Clinic

  • Rural Health Clinic/Center
  • Wapello, IA
National Provider Identifier
1376230326
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HENRY COUNTY HEALTH CENTER, INC.
Doing business as
Henry County Health Center-Wapello Clinic
Practice address
220 Mulberry St Ste a
Wapello, IA 52653-1570
Phone
(888) 377-7791
NPI assigned
Apr 20, 2023
Last updated
Nov 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Teresa Lynn Colgan
Title
Ceo
Phone
(319) 385-6560

Specialties & licenses 1

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

Addresses

Primary practice location

220 Mulberry St Ste a
Wapello, IA 52653-1570

Mailing address

1221 S Gear Ave
Attn: Legal Services
West Burlington, IA 52655-1679

Other names 1

  • Henry County Health Center-Wapello Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241019000280 IA Part A Provider - Rural Health Clinic 9638570740 Practice locations: Wapello, IA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1376230326. Details of each certification follow.

Rural health clinic certification: CCN 168672

Legal name
HENRY COUNTY HEALTH CENTER INC
Doing business as
HENRY COUNTY HEALTH CENTER-WAPELLO CLINIC
Organization structure
GovernmentNon-profit
Enrollment address
220 Mulberry St
Ste a
Wapello, IA 52653-1576

Rural health clinic certification: CCN 163849

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
HENRY COUNTY HEALTH CENTER-WAPELLO CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 28, 1994
Last certification
Jul 5, 2023
Ownership / control type
2B
Most recent change of ownership
Jul 1, 2021 (1 total)
Facility address
220 Mulberry, Suite a
Wapello, IA 52653

Other NPIs with the same Medicare PAC ID 7

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
16D0387511Henry County Health Center-Wapello Clinic220 Mulberry, Suite a, Wapello, IA 52653Certificate of waiverApr 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Henry County Health Center Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Robert Engberg Individual Corporate Director Jul 1, 2021
Michael Yost Individual W-2 Managing EmployeeChief Human Resources Officer Feb 13, 2023
Michael J McCoy Individual Corporate Officer Nov 16, 2022
Teresa Colgan Individual Corporate OfficerCeo Jul 1, 2022
W-2 Managing EmployeeCeo Jul 1, 2022
David File Individual Corporate Director Jul 1, 2021
Deanna a Barr Individual Corporate Director Jul 1, 2021
Jeremy Alexander Individual W-2 Managing EmployeeCfo Dec 3, 2018
Whitney Rogers Individual Corporate Director Jul 1, 2021
Jennifer Moutrie Individual Corporate Director Feb 28, 2023
Russell Rodriguez Individual W-2 Managing EmployeeChief Clinical Operations Officer Aug 1, 2022
Chad Hudson Individual Corporate Director Mar 29, 2023
Gina Riherd Individual Corporate DirectorBoard Member Jul 1, 2025
Sara Beth Schurr Individual Corporate Director Jul 1, 2021
Douglas Martin Individual Corporate Director Jul 1, 2021
Hope Dunn Individual W-2 Managing EmployeeCno Jun 27, 2022
John P McKillip Individual Corporate Director Jul 1, 2021
Carla McNamee Individual Corporate Director Jul 1, 2021
Tomi Hagan Individual W-2 Managing EmployeeChief Compliance Officer Dec 3, 2018
Joseph P Tansey Individual Corporate Director Feb 28, 2023
Todd Chelf Individual W-2 Managing EmployeeGeneral Counsel Jan 18, 2021
Joel Ryon Individual W-2 Managing EmployeeCmo Jan 23, 2023
Great River Health System Inc Organization, West Burlington, IA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2021 100%

Owners & managing parties with NPI records 2

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

Facilities with the same owner 11

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

Change-of-ownership history 1

DateEventCounterparty
Oct 1, 2023 Change of OwnershipThis provider was the buyer Wapello ClinicCCN 163849, IA, NPI 1154996411

NPI Registry JSON

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1376230326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S GEAR AVE",
            "address_2": "ATTN: LEGAL SERVICES",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 MULBERRY ST STE A",
            "city": "WAPELLO",
            "state": "IA",
            "postal_code": "526531570",
            "telephone_number": "888-377-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY COUNTY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-20",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "COLGAN",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-385-6560"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry County Health Center-Wapello Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henry County Health Center-Wapello Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wapello, IA

Sources for this page

Verify at the official NPI Registry.