NPIMap

Organization Active NPI

Henry County Health Center, Inc.

Doing business as Henry County Health Center-Keokuk Clinic

  • Rural Health Clinic/Center
  • Keokuk, IA
National Provider Identifier
1750157467
Registry record updated Dec 4, 2023
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-Keokuk Clinic
Practice address
3285 Main St
Keokuk, IA 52632-2263
Phone
(319) 524-6274
NPI assigned
Dec 4, 2023
Last updated
Dec 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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 Primary

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 1

  • Henry County Health Center-Keokuk Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240321001157 IA Part A Provider - Rural Health Clinic 9638570740 Practice locations: Keokuk, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750157467. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
3285 Main St
Keokuk, IA 52632-2263
Related CCNs
161356

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

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
16D2299294Henry County Health Center- Keokuk Clinic3285 Main St, Keokuk, IA 52632Certificate of waiverFeb 15, 2028

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.

Locations

3285 Main St
Keokuk, IA 52632
Phone (319) 524-6274

1221 S Gear Ave
West Burlington, IA 52655
Phone (319) 768-3622

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 21, 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 21, 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 21, 2021
Hope Dunn Individual W-2 Managing EmployeeCno Jun 27, 2022
John P McKillip Individual Corporate Director Jul 21, 2021
Carla McNamee Individual Corporate Director Jul 21, 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.

NPI Registry JSON

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1750157467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S GEAR AVE",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551679",
            "telephone_number": "319-768-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3285 MAIN ST",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "526322263",
            "telephone_number": "319-524-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY COUNTY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-02",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry County Health Center-Keokuk Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Keokuk, IA

Sources for this page

Verify at the official NPI Registry.