NPIMap

Organization Active NPI

Madison County Memorial Hospital

Doing business as Earlham Medical Clinic

  • Rural Health Clinic/Center
  • Earlham, IA
National Provider Identifier
1497810097
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MADISON COUNTY MEMORIAL HOSPITAL
Doing business as
Earlham Medical Clinic
Practice address
137 W 1St St
Earlham, IA 50072-7717
Phone
(515) 758-2907
NPI assigned
Dec 26, 2006
Last updated
Aug 12, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MADISON COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Authorized official

Name
Marcia L Hendricks
Title
Ceo
Phone
(515) 462-2373

Specialties & licenses 1

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

Addresses

Primary practice location

137 W 1St St
Earlham, IA 50072-7717

Mailing address

300 W Hutchings St
Winterset, IA 50273-2104
Phone (515) 462-2373

Other names 1

  • Earlham Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030919000024 IA Part A Provider - Rural Health Clinic 6002727179 Practice locations: Earlham, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497810097. Details of each certification follow.

Rural health clinic certification: CCN 163486

Legal name
MADISON COUNTY MEMORIAL HOSPITAL
Doing business as
EARLHAM MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 1, 2002
Last certification
Feb 18, 2021
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
137 W 1St St
Earlham, IA 50072-7717
Related CCNs
161326

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

Other NPIs with the same Medicare PAC ID 4

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
16D0947407Earlham Medical Clinic137 W 1St St, Earlham, IA 50072Certificate of waiverMar 15, 2028

National Provider Directory

National Provider Directory
Tax ID family
Cooper Ste6 organizations share this tax ID, including this one
Part of
Cooper Ste

Other organizations with this tax ID 5

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

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
Elisa L Perry Individual W-2 Managing EmployeeAd;Clinic Director Jun 29, 2017
Operational/Managerial ControlClinic Director Jun 29, 2017
Jared McDonald Individual Corporate Officer Sep 26, 2019
Corporate Director May 28, 2015
Sarah C. Nigg Individual Corporate Director May 9, 2024
Brian K Gibson Individual Corporate Officer Dec 1, 2022
Corporate Director Dec 14, 2021
Mercy Health Network Inc Organization, Clive, IA Corporation, Management services company, Non-profit Operational/Managerial Control Nov 1, 2012
Julie R Plant Individual Corporate Director Jan 22, 2026
Jacque Mohs Individual Corporate Officer Jan 1, 2021
Corporate Director Jul 23, 2015
Sharon Carlson Individual Corporate Director Jan 26, 2017
Ambrose B Munro Individual W-2 Managing EmployeeMD; Mar 1, 2026
Operational/Managerial ControlMedical Director Mar 1, 2026
Audra C Ford Individual Corporate OfficerCfo Sep 2, 2024
W-2 Managing EmployeeCfo Sep 2, 2024
Operational/Managerial ControlCfo Sep 2, 2024
Gary R Van Dyke Individual Corporate Director Jan 1, 2025
Marcia L. Hendricks Individual Contracted Managing EmployeeCeo Sep 8, 2003
Corporate OfficerCeo Jun 23, 2016
Operational/Managerial ControlCeo Sep 8, 2003

Owners & managing parties with NPI records 1

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

Facilities with the same owner 98

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

View all 98

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1497810097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HUTCHINGS ST",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "502732104",
            "telephone_number": "515-462-2373",
            "fax_number": "515-462-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 W 1ST ST",
            "city": "EARLHAM",
            "state": "IA",
            "postal_code": "500727717",
            "telephone_number": "515-758-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MADISON COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2006-12-26",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-462-2373"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Earlham Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Earlham, IA

Sources for this page

Verify at the official NPI Registry.