NPIMap

Organization Active NPI

Hawarden Regional Healthcare

Doing business as Akron Clinic

  • Rural Health Clinic/Center
  • Akron, IA
National Provider Identifier
1487289955
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HAWARDEN REGIONAL HEALTHCARE
Doing business as
Akron Clinic
Practice address
321 Mill St
Akron, IA 51001-7712
Phone
(712) 568-2411
NPI assigned
Mar 5, 2020
Last updated
Mar 16, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
HAWARDEN REGIONAL HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Authorized official

Name
Mr. Jayson Pullman
Title
Ceo
Phone
(712) 551-3100

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

321 Mill St
Akron, IA 51001-7712

Mailing address

1111 11TH St
Hawarden, IA 51023-1903
Phone (712) 551-3100

Other names 1

  • Akron Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200501000241 IA Part A Provider - Rural Health Clinic 0547257990 Practice locations: Akron, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487289955. Details of each certification follow.

Rural health clinic certification: CCN 168641

Legal name
HAWARDEN REGIONAL HEALTHCARE
Doing business as
AKRON CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 1, 2020
Last certification
Aug 24, 2021
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
321 Mill St
Akron, IA 51001-7712
Related CCNs
161311

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

Other NPIs with the same Medicare PAC ID 2

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
16D0385020Akron Clinic - HRH321 Mill Street, Akron, IA 51001Certificate of waiverJun 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Hawarden Regional Healthcare4 organizations share this tax ID, including this one
Part of
Hawarden Regional Healthcare

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Israel Curiel Individual Corporate Director Feb 28, 2019
Kelsi a Brunsting Individual W-2 Managing EmployeeAd;RHC Clinic Director Apr 30, 2025
Operational/Managerial ControlRHC Clinic Director Apr 30, 2025
Stanley Hoekstra Individual Corporate Officer Jan 23, 2020
Corporate Director Oct 24, 2007
Mercy Health Network Inc Organization, Clive, IA Corporation, Management services company, Non-profit Operational/Managerial Control Aug 1, 2016
Matthew Hummel Individual Corporate Officer Feb 1, 2006
Corporate Director Jan 27, 2000
Madison L Bartels Individual W-2 Managing EmployeeDirector of Finance Apr 17, 2023
Operational/Managerial ControlDirector of Finance Apr 17, 2023
Emma L Bouza Individual Corporate Director Jan 23, 2020
Richard C Andersen Individual Contracted Managing EmployeeMD; Jul 1, 2025
Operational/Managerial ControlMedical Director Jul 1, 2025
Dennis M Hulshof Individual Corporate Officer Feb 4, 2016
Corporate Director Jan 27, 2010
Jayson P Pullman Individual Contracted Managing EmployeeCeo Oct 5, 2011
Corporate OfficerCeo Mar 31, 2020
Operational/Managerial ControlCeo Oct 5, 2011

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hawarden ClinicHawarden, IA, CCN 168503 Rural health clinic 5% Or Greater Direct Ownership Interest (50%)
Operational/Managerial Control		 Aug 3, 2004
Aug 3, 2004

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 98

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

View all 98

Change-of-ownership history 1

DateEventCounterparty
May 1, 2020 Change of OwnershipThis provider was the buyer Mercyone Akron Family MedicineCCN 163830, IA, NPI 1902840671

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584316800000",
    "number": "1487289955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 11TH ST",
            "city": "HAWARDEN",
            "state": "IA",
            "postal_code": "510231903",
            "telephone_number": "712-551-3100",
            "fax_number": "712-551-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MILL ST",
            "city": "AKRON",
            "state": "IA",
            "postal_code": "510017712",
            "telephone_number": "712-568-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWARDEN REGIONAL HEALTHCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAWARDEN REGIONAL HEALTHCARE",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A",
        "authorized_official_last_name": "PULLMAN",
        "authorized_official_first_name": "JAYSON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "712-551-3100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Akron Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Akron, IA

Sources for this page

Verify at the official NPI Registry.