NPIMap

Organization Active NPI

Waverly Health Center

Doing business as Nashua Clinic

  • Rural Health Clinic/Center
  • Nashua, IA
National Provider Identifier
1447432174
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WAVERLY HEALTH CENTER
Doing business as
Nashua Clinic
Practice address
80 Amhearst Boulevard
Suite 400
Nashua, IA 50658-9712
Phone
(641) 435-4133
NPI assigned
Dec 5, 2007
Last updated
Jun 5, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WAVERLY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Authorized official

Name
Ms. Jodi M Geerts
Title
Ceo
Phone
(319) 352-4120

Specialties & licenses 1

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

Addresses

Primary practice location

80 Amhearst Boulevard
Suite 400
Nashua, IA 50658-9712

Mailing address

312 9TH St SW
Waverly, IA 50677-2929
Phone (319) 352-4120

Other names 1

  • Nashua Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071221000461 IA Part A Provider - Rural Health Clinic 8820996762 Practice locations: Nashua, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447432174. Details of each certification follow.

Rural health clinic certification: CCN 168527

Legal name
WAVERLY HEALTH CENTER
Doing business as
NASHUA CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 1, 2008
Last certification
Jan 19, 2023
Ownership / control type
2B
Organization structure
OtherNon-profit
Enrollment address
80 Amhearst Blvd
Ste 400
Nashua, IA 50658-9712
Related CCNs
161339

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

Other NPIs with the same Medicare PAC ID 9

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
16D1076320Waverly Health Center80 Amhearst Boulevard, Suite 400, Nashua, IA 50658Certificate of waiverJun 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Waverly Municipal Hospital13 organizations share this tax ID, including this one
Part of
Waverly Municipal Hospital

Other organizations with this tax ID 12

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

Locations

80 Amherst Blvd
Ste 400
Nashua, IA 50658
Phone (641) 435-4133

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Ann Henninger Trax Individual Corporate Officer Jan 7, 2022
Corporate Director Jan 1, 2020
Courtney C Bochmann Individual W-2 Managing EmployeeMedical Director Jul 1, 2022
Operational/Managerial ControlMedical Director Jul 1, 2022
Jodi M Geerts Individual Corporate OfficerCeo Jan 18, 2023
W-2 Managing EmployeeCeo Jan 18, 2023
Operational/Managerial ControlCeo Jan 18, 2023
Philip S Jones Individual Corporate Officer Jan 7, 2022
Corporate Director Aug 31, 2021
David J Rathe Individual Corporate Director Jan 1, 2024
Laurie Everhardt Individual Corporate Director Jan 1, 2022
Nicole C Myers Individual W-2 Managing EmployeeAd;Chief Clinic Officer May 16, 2023
Operational/Managerial ControlChief Clinic Officer May 16, 2023

Owners & managing parties with NPI records 2

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

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1447432174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 9TH ST SW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772929",
            "telephone_number": "319-352-4120",
            "fax_number": "319-352-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 AMHEARST BOULEVARD",
            "address_2": "SUITE 400",
            "city": "NASHUA",
            "state": "IA",
            "postal_code": "506589712",
            "telephone_number": "641-435-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVERLY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAVERLY HEALTH CENTER",
        "enumeration_date": "2007-12-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "GEERTS",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-352-4120",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nashua Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nashua, IA

Sources for this page

Verify at the official NPI Registry.