Hawarden Regional Healthcare Clinics LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HAWARDEN REGIONAL HEALTHCARE CLINICS LLC

Practice address

318 Main St
Ireton, IA 51027-7794

Phone

(712) 278-1011

Fax

(712) 551-2691

NPI assigned

Apr 15, 2008

Organization subpart

No

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

Authorized official

Name

Jayson P Pullman

Title

President

Phone

(712) 551-3103

Specialties & licenses 2

Addresses

Other names 1

• IRETON CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Hawarden Regional Healthcare Clinics LLC

  • Rural Health Clinic/Center
  • Hawarden, IA
  • NPI 1013955004

  O20050411000652

  Same enrollment
• Hawarden Regional Healthcare Clinics LLC

  • Family Medicine Physician
  • Hawarden, IA
  • NPI 1750324612

  O20050411000652

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Hawarden Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Hawarden Regional Healthcare Clinics LLC

  • Rural Health Clinic/Center
  • Hawarden, IA
  • NPI 1013955004
  NPD tax ID

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Hawarden Regional Healthcare

  • Medicare Defined Swing Bed Hospital Unit
  • Hawarden, IA
  • NPI 1790740884

  Member Of

  NPD member
• Mercy Health Services-Iowa Corp

  • Pharmacy
  • Clear Lake, IA
  • NPI 1639625155

  Member Of

  NPD member
• Mercy Medical Services

  • Family Medicine Physician
  • Sioux City, IA
  • NPI 1750889325

  Member Of

  NPD member

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rodrigo Ernesto Banda, PA-C

  • Physician Assistant
  • Sheldon, IA
  • NPI 1487401642
  NPD
• David Solomon De Guzman Chua

  • Internal Medicine Physician
  • Hawarden, IA
  • NPI 1023268646
  NPD
• Paul R. Niles, PA-C

  • Medical Physician Assistant
  • Akron, IA
  • NPI 1932384971
  NPD
• Kelly Scott Pomerenke, M.D.

  • Family Medicine Physician
  • Primghar, IA
  • NPI 1205826641

  Family Medicine

  NPD
• Mackenzie Jona Warner, CNP

  • Nurse Practitioner
  • Sioux Falls, SD
  • NPI 1376229344

  Family

  NPD

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1801060306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 12TH ST",
            "city": "HAWARDEN",
            "state": "IA",
            "postal_code": "510231900",
            "telephone_number": "712-551-3400",
            "fax_number": "712-551-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 MAIN ST",
            "city": "IRETON",
            "state": "IA",
            "postal_code": "510277794",
            "telephone_number": "712-278-1011",
            "fax_number": "712-551-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWARDEN REGIONAL HEALTHCARE CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "PULLMAN",
        "authorized_official_first_name": "JAYSON",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-551-3103"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IRETON CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brenna Ann Anema, IBCLC
• Greater Sioux Community Health Center, Inc
• Ireton Community Fire Department Inc
• Cindi S Rule, ARNP
• Jenna Ann Weyen, NP

• All providers in Ireton, IA
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.