NPIMap

Organization Active NPI

Henry County Health Center, Inc.

Doing business as Henry County Health Center - Mt. Pleasant Clinic

  • Rural Health Clinic/Center
  • Mt Pleasant, IA
National Provider Identifier
1770167389
Registry record updated Nov 4, 2024
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 - Mt. Pleasant Clinic
Practice address
407 S White St Ste 103, 28
Mount Pleasant, IA 52641-2263
Phone
(319) 385-3141
NPI assigned
May 10, 2021
Last updated
Nov 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

407 S White St Ste 103, 28
Mount Pleasant, IA 52641-2263

Mailing address

1221 S Gear Ave
Legal Services
West Burlington, IA 52655-1679
Phone (197) 683-6223

Other names 1

  • Henry County Health Center - Mt. Pleasant Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210628001327 IA Part A Provider - Rural Health Clinic 9638570740 Practice locations: Mount Pleasant, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770167389. Details of each certification follow.

Rural health clinic certification: CCN 168616

Legal name
HENRY COUNTY HEALTH CENTER INC
Doing business as
HENRY COUNTY HEALTH CENTER - MT. PLEASANT CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 21, 2019
Last certification
Mar 21, 2019
Ownership / control type
2B
Most recent change of ownership
Jul 1, 2021 (1 total)
Organization structure
GovernmentNon-profit
Enrollment address
407 S White St
Ste 103, 28
Mount Pleasant, IA 52641-2263
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).

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

407 S White St
Ste 103
Mt Pleasant, IA 52641
Phone (319) 385-6166

Ownership & related parties

All disclosed owners & managing parties 23

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 1, 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 100%
W-2 Managing EmployeeCeo Jul 1, 2022 100%
David File Individual Corporate Director Jul 1, 2021
Deanna a Barr Individual Corporate Director Jul 1, 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 1, 2021
Hope Dunn Individual W-2 Managing EmployeeCno Jun 27, 2022
John P McKillip Individual Corporate Director Jul 1, 2021
Carla McNamee Individual Corporate Director Jul 1, 2021
Tomi Hagan Individual W-2 Managing EmployeeChief Compliance Officer Dec 3, 2018
Devan Rhum Individual Contracted Managing EmployeeClinic Director Jul 1, 2021
Operational/Managerial ControlClinic Director Jul 1, 2021
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.

Change-of-ownership history 1

DateEventCounterparty
Jul 1, 2021 Change of OwnershipThis provider was the buyer Physicians & Clinics of HCHC - Mt PleasantCCN 168616, IA, NPI 1467404103

Change of ownership 1

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

NPI Registry JSON

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1770167389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S GEAR AVE",
            "address_2": "LEGAL SERVICES",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551679",
            "telephone_number": "197-683-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S WHITE ST STE 103, 28",
            "city": "MOUNT PLEASANT",
            "state": "IA",
            "postal_code": "526412263",
            "telephone_number": "319-385-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY COUNTY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-10",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "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 - Mt. Pleasant Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mt Pleasant, IA

Sources for this page

Verify at the official NPI Registry.