NPIMap

Organization Active NPI

Greater Sioux Community Health Center, Inc

Doing business as Promise CHC Hawarden Elementary

  • Federally Qualified Health Center (FQHC)
  • Hawarden, IA
National Provider Identifier
1831939859
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GREATER SIOUX COMMUNITY HEALTH CENTER, INC
Doing business as
Promise CHC Hawarden Elementary
Practice address
800 13TH St
Hawarden, IA 51023
Phone
(712) 551-1454
Fax
(712) 551-2829
NPI assigned
May 28, 2024
Last updated
May 28, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
GREATER SIOUX COMMUNITY HEALTH CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Authorized official

Name
Emily Tuschen
Title
Ceo
Phone
(712) 722-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

800 13TH St
Hawarden, IA 51023

Mailing address

33 4TH St NW
Sioux Center, IA 51250-1870
Phone (712) 722-1700

Other names 1

  • Promise CHC Hawarden Elementary Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080717000707 IA Part B Supplier - Clinic/Group Practice 3173696572 Receives reassigned benefits from 15 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sioux Center, IA; Rock Valley, IA; Ireton, IA; Hawarden, IA
O20240730003995 IA Part A Provider - Federally Qualified Health Center (FQHC) 3173696572 Practice locations: Hawarden, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831939859. Details of each certification follow.

Federally qualified health center certification: CCN 161032

Legal name
GREATER SIOUX COMMUNITY HEALTH CENTER INC
Doing business as
PROMISE CHC HAWARDEN ELEMENTARY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 17, 2024
Last certification
Sep 17, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
800 13TH St
RM 107
Hawarden, IA 51023-1834

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Greater Sioux Community Health Center8 organizations share this tax ID, including this one
Part of
Greater Sioux Community Health Center

Other organizations with this tax ID 7

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

Locations

800 13th St
Hawarden, IA 51023
Phone (712) 551-1454

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kendra Rensink Individual Corporate Director Sep 27, 2019
Greta Grond Individual Corporate Director Oct 26, 2018
Janice Luevano Individual Corporate Director Jan 26, 2024
Michele Hofman Individual Corporate Director Dec 15, 2023
Amy McAlpine Individual Corporate OfficerCoo Aug 15, 2022
Corporate DirectorCoo Aug 15, 2022
W-2 Managing Employee Aug 15, 2022
Nancy Anguiano Individual Corporate Director Jan 24, 2020
Rick Getman Individual Corporate Director Dec 15, 2023
Jean Ellis Individual Corporate Director Oct 29, 2021
Emily Tuschen Individual Corporate OfficerCeo Dec 1, 2018
Corporate DirectorCeo Dec 1, 2018
W-2 Managing Employee Dec 1, 2018
Kara Acevedo Individual Corporate Officer Dec 24, 2023
Corporate Director Dec 24, 2023
W-2 Managing Employee Dec 24, 2023
Daisy Gasca Individual Corporate Director Oct 21, 2022
Verlyn Boone Individual Corporate Director Oct 26, 2018
Lilian Morales-Lopez Individual Corporate Director Sep 23, 2022

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1831939859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 4TH ST NW",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512501870",
            "telephone_number": "712-722-1700",
            "fax_number": "712-722-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 13TH ST",
            "city": "HAWARDEN",
            "state": "IA",
            "postal_code": "51023",
            "telephone_number": "712-551-1454",
            "fax_number": "712-551-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER SIOUX COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREATER SIOUX COMMUNITY HEALTH CENTER, INC",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "TUSCHEN",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "712-722-1700"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Promise CHC Hawarden Elementary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hawarden, IA

Sources for this page

Verify at the official NPI Registry.