NPIMap

Organization Active NPI

Community Health Centers of Southeastern Iowa, Inc

  • Federally Qualified Health Center (FQHC)
  • West Burlington, IA
National Provider Identifier
1881418374
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA, INC
Practice address
408 W Van Weiss Blvd RM 159
West Burlington, IA 52655-1536
Phone
(319) 768-5858
NPI assigned
Nov 11, 2024
Last updated
Nov 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Authorized official

Name
James Kammerer
Title
Interim Ceo
Phone
(319) 753-2300

Specialties & licenses 1

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

Addresses

Primary practice location

408 W Van Weiss Blvd RM 159
West Burlington, IA 52655-1536

Mailing address

1706 W Agency Rd
West Burlington, IA 52655-1667
Phone (319) 753-2300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040219000446 IA Part B Supplier - Clinic/Group Practice 4486562527 Receives reassigned benefits from 40 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Burlington, IA; Columbus City, IA; Keokuk, IA; West Burlington, IA

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
Community Health Centers of Southeastern Iowa 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

408 W Van Weiss Blvd
Rm 159
West Burlington, IA 52655
Phone (319) 768-5858

NPI Registry JSON

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1881418374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 W AGENCY RD",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551667",
            "telephone_number": "319-753-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 W VAN WEISS BLVD RM 159",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551536",
            "telephone_number": "319-768-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "KAMMERER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "319-753-2300"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Burlington, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.