NPIMap

Organization Active NPI

Alegent Health - Mercy Hospital, Corning, Iowa

Doing business as CHI Health Clinic Corning

  • Rural Health Clinic/Center
  • Corning, IA
National Provider Identifier
1952486433
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
023480 Issued in IA
Legal business name
ALEGENT HEALTH - MERCY HOSPITAL, CORNING, IOWA
Doing business as
CHI Health Clinic Corning
Practice address
601 Rosary Dr
Corning, IA 50841-1683
Phone
(641) 322-5245
Fax
(641) 322-4687
NPI assigned
Oct 25, 2006
Last updated
Feb 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Evert Kuiper
Title
Ceo - CHI Health
Phone
(402) 343-4420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 023480 IA Primary

Addresses

Primary practice location

601 Rosary Dr
Corning, IA 50841-1683

Mailing address

601 Rosary Dr
Corning, IA 50841-1683
Phone (641) 322-5245

Other names 1

  • CHI Health Clinic Corning Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070530000087 IA Part A Provider - Rural Health Clinic 0547154940 Practice locations: Corning, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952486433. Details of each certification follow.

Rural health clinic certification: CCN 163480

Legal name
ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA
Doing business as
CHI HEALTH CLINIC CORNING
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 1, 1999
Last certification
Feb 24, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
601 Rosary Dr
Corning, IA 50841-1683
Related CCNs
161304

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Alegent Health Clinics5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
CHI Nebraska Organization, Omaha, NE Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 1, 2013 100%
Nadine a Heimann Individual Corporate Director Jul 1, 2019
Maurita Soukup Individual Corporate Director Jul 1, 2017
Leo G Searcey Individual Corporate DirectorBoard Member Oct 20, 2022
Commonspirit Health Organization, Chicago, IL Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Aug 1, 2013 100%
Dave R Taylor Individual Corporate DirectorBoard Member Oct 20, 2022
Daniel Morissette Individual Corporate OfficerCfo- Commonspirit Health Feb 1, 2019
Alicia Reed Individual Operational/Managerial ControlPresident Feb 18, 2022
Cindy a Alloway Individual Corporate DirectorBoard Member Jul 1, 2023
Tim Bricker Individual Corporate OfficerMid West Div Ceo Jul 1, 2023
Corporate DirectorBoard Member Jul 1, 2023
William Barney Individual Corporate Director Jul 1, 2020
Kevin Fitzgerald Individual Corporate DirectorBod Jul 15, 2021
Nick O'Tool Individual Corporate OfficerMarket Cfo- Div Admin Jul 1, 2023
Operational/Managerial ControlMRK Cfo - Div Admin Jan 7, 2023
Heather M Morgan Individual Corporate Director Jul 1, 2020
Kirtibala Gupta Individual Corporate DirectorBod Jul 15, 2021
John E Petersdorf Individual Corporate Director Jan 21, 2021
Mardell Wilson Individual Corporate Director Oct 15, 2020
Kathryne Alyce Cutler Individual Corporate DirectorBoard Member Jul 1, 2023
Kelly Bacon Individual Corporate DirectorBod Jul 15, 2021

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 38

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1952486433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ROSARY DR",
            "city": "CORNING",
            "state": "IA",
            "postal_code": "508411683",
            "telephone_number": "641-322-5245",
            "fax_number": "641-322-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ROSARY DR",
            "city": "CORNING",
            "state": "IA",
            "postal_code": "508411683",
            "telephone_number": "641-322-5245",
            "fax_number": "641-322-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEGENT HEALTH - MERCY HOSPITAL, CORNING, IOWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "KUIPER",
        "authorized_official_first_name": "EVERT",
        "authorized_official_title_or_position": "CEO - CHI HEALTH",
        "authorized_official_telephone_number": "402-343-4420"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IA",
            "license": "023480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI Health Clinic Corning",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHI Health Clinic Corning",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corning, IA

Sources for this page

Verify at the official NPI Registry.