Henry County Health Center, Inc.
Organization Active NPI Rural Health Clinic/Center · Keokuk, IA
NPI 1750157467 · NPPES record last updated Dec 4, 2023
Key facts
- NPI
- 1750157467
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- HENRY COUNTY HEALTH CENTER, INC.
- Practice address
- 3285 Main St
Keokuk, IA 52632-2263 - Phone
- (319) 524-6274
- NPI assigned
- Dec 4, 2023
- Organization subpart
- No
Authorized official
- Name
- Teresa Lynn Colgan
- Title
- Ceo
- Phone
- (319) 385-6560
Owners & managing parties with NPI records 2
-
Joel Ryon, MD
-
Joseph P Tansey, 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 11
Practitioners 52
-
Kendra M Bonnesen, ARNP, FNP-C
-
Patrick Bredar, P.A.
-
Sindy Ivelsse Carrillo Lopez, DNP, ARNP, FNP-C
-
Joyce L Chouinard, ARNP
-
Jennifer Cooper, ARNP
-
Steven Davis, M.D.
-
Mackenzie Rae Delaney, FNP-C
-
David E. Fishbaugher, M.D.
-
Raymond Harre, MD
-
Emily Elizabeth Helling, PA-C
-
Matthew John Hoffman, D.O.
-
Stephanie Nichole Johnson, A.R.N.P
-
Samir Virendra Patel, M.D.
-
Kari Payne, ARNP, CNM
-
Bailey Peterson, LMSW
-
Joel Ryon, MD
-
Alicia E Schrader, D.O.
-
Trina Jenae Smith, ARNP
-
Joseph P Tansey, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D2299294 | Henry County Health Center- Keokuk Clinic | Certificate of waiver | Feb 15, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Rural health clinic certification: CCN 168670
- Legal name
- HENRY COUNTY HEALTH CENTER INC
- Doing business as
- HENRY COUNTY HEALTH CENTER-KEOKUK CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jun 18, 2024
- Last certification
- Jun 18, 2024
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 3285 Main St
Keokuk, IA 52632-2263 - Related CCNs
- 161356
All disclosed owners & managing parties 22
| Name | Role | Since | Share |
|---|---|---|---|
| Robert Engberg |
Corporate Director | Jul 21, 2021 | |
| Michael Yost |
W-2 Managing Employee |
Feb 13, 2023 | |
| Michael J McCoy |
Corporate Officer | Nov 16, 2022 | |
| Teresa Colgan |
Corporate Officer |
Jul 1, 2022 | |
| W-2 Managing Employee |
Jul 1, 2022 | ||
| David File |
Corporate Director | Jul 1, 2021 | |
| Deanna a Barr |
Corporate Director | Jul 21, 2021 | |
| Jeremy Alexander |
W-2 Managing Employee |
Dec 3, 2018 | |
| Whitney Rogers |
Corporate Director | Jul 1, 2021 | |
| Jennifer Moutrie |
Corporate Director | Feb 28, 2023 | |
| Russell Rodriguez |
W-2 Managing Employee |
Aug 1, 2022 | |
| Chad Hudson |
Corporate Director | Mar 29, 2023 | |
| Gina Riherd |
Corporate Director |
Jul 1, 2025 | |
| Sara Beth Schurr |
Corporate Director | Jul 1, 2021 | |
| Douglas Martin |
Corporate Director | Jul 21, 2021 | |
| Hope Dunn |
W-2 Managing Employee |
Jun 27, 2022 | |
| John P McKillip |
Corporate Director | Jul 21, 2021 | |
| Carla McNamee |
Corporate Director | Jul 21, 2021 | |
| Tomi Hagan |
W-2 Managing Employee |
Dec 3, 2018 | |
| Joseph P Tansey |
Corporate Director | Feb 28, 2023 | |
| Todd Chelf |
W-2 Managing Employee |
Jan 18, 2021 | |
| Joel Ryon |
W-2 Managing Employee |
Jan 23, 2023 | |
| Great River Health System Inc |
5% Or Greater Direct Ownership Interest | Jul 1, 2021 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240321001157 | IA | Part a Provider - Rural Health Clinic | 9638570740 | Practice locations: Keokuk, IA |
National Provider Directory
- Tax ID family
- Henry County Health Center Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
3285 Main St
Keokuk, IA 52632-2263
Mailing address
1221 S Gear Ave
West Burlington, IA 52655-1679
Phone (319) 768-1000
Other names
- Henry County Health Center-Keokuk Clinic
Other providers in Keokuk, IA
- Healthstat Onsite Clinic Amsted GW Iowa
- Heartland Pathways Inc
- Rita Hellweg
- Theresa R Hemann
- Alexis Hennigar
- James F Holsinger
- Sara Florence Holvoet
- Hope Home Healthcare
- Alycia Ann Hopp
- Joshua Hucklenbrick
All providers in Keokuk, 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 Dec 4, 2023. 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.