NPIMap

Organization Active NPI

Ottumwa Health Group LLC

Doing business as The Eddyville Clinic

  • Rural Health Clinic/Center
  • Eddyville, IA
National Provider Identifier
1962023663
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
OTTUMWA HEALTH GROUP LLC
Doing business as
The Eddyville Clinic
Practice address
107 N 3Rd St
Eddyville, IA 52553-7709
Phone
(641) 969-5212
NPI assigned
May 4, 2020
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 1

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

Addresses

Primary practice location

107 N 3Rd St
Eddyville, IA 52553-7709

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Other names 1

  • The Eddyville Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100927001257 IA Part B Supplier - Clinic/Group Practice 3971629924 Receives reassigned benefits from 86 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sigourney, IA; Centerville, IA; Ottumwa, IA; Fairfield, IA; Eddyville, IA; Bloomfield, IA
O20200612000646 IA Part A Provider - Rural Health Clinic 3971629924 Practice locations: Eddyville, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962023663. Details of each certification follow.

Rural health clinic certification: CCN 168977

Legal name
OTTUMWA HEALTH GROUP LLC
Doing business as
THE EDDYVILLE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 29, 2020
Last certification
Oct 29, 2020
Ownership / control type
1B
Organization structure
LLCProprietary
Enrollment address
107 N 3Rd St
Eddyville, IA 52553-7709

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 5

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0977193Ottumwa Health Group, LLC107 North Third Street, Eddyville, IA 52553Certificate of waiverAug 21, 2026

National Provider Directory

National Provider Directory
Tax ID family
Ottumwa Health Group LLC5 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 12

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

NameRoleSinceShare
Pamela Kane Individual Corporate OfficerVice President Aug 9, 2022
DSB Acquisition LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Jun 1, 2023 100%
Laura C Hinson Individual Corporate OfficerChief Financial Officer Mar 12, 2025
Ottumwa Physicians LLC Organization, Brentwood, TN LLC 5% Or Greater Direct Ownership Interest Jun 1, 2023 100%
Lifepoint Health Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Jun 1, 2023 100%
Charlotte E Lawrence Individual Corporate OfficerSecretary Jun 1, 2023
Regionalcare Hospital Partners LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Jun 1, 2023 100%
RCHP-Ottumwa Holdings Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Jun 1, 2023 100%
Elliott Brown Individual Corporate OfficerSenior Vice President and Treasurer Apr 2, 2026
RCHP LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Jun 1, 2023 100%
Klaus Michael Boel Individual Corporate OfficerPresident Aug 19, 2024
W-2 Managing Employee Aug 19, 2024
Christopher J Monte Individual Corporate OfficerVice President Jun 1, 2023

Facilities with the same owner 19

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

  • Ottumwa Health Group LLC

    dba Ottumwa Women's Health Clinic

    • Rural Health Clinic/Center
    • Ottumwa, IA
    • NPI 1336919364

    Ottumwa Physicians LLC, RCHP LLC, RCHP-Ottumwa Holdings Inc, Regionalcare Hospital Partners LLC

    CMS ownership
  • Ottumwa Health Group LLC

    dba Ottumwa Primary Care Clinic

    • Rural Health Clinic/Center
    • Ottumwa, IA
    • NPI 1639861990

    Ottumwa Physicians LLC, RCHP LLC, RCHP-Ottumwa Holdings Inc, Regionalcare Hospital Partners LLC

    CMS ownership
  • Ottumwa Health Group LLC

    dba EasyCare Walk In Clinic

    • Rural Health Clinic/Center
    • Ottumwa, IA
    • NPI 1649891722

    Ottumwa Physicians LLC, RCHP LLC, RCHP-Ottumwa Holdings Inc, Regionalcare Hospital Partners LLC

    CMS ownership
  • RCHP Ottumwa LLC

    dba Ottumwa Regional Health Center

    • General Acute Care Hospital
    • Ottumwa, IA
    • NPI 1013233741

    RCHP-Ottumwa Holdings Inc

    CMS ownership
  • RCHP Ottumwa LLC

    dba Ottumwa Regional Health Center

    • Rehabilitation Hospital Unit
    • Ottumwa, IA
    • NPI 1477879195

    RCHP-Ottumwa Holdings Inc

    CMS ownership
  • RCHP Ottumwa LLC

    dba Senior Behavioral Care Center

    • Psychiatric Hospital Unit
    • Ottumwa, IA
    • NPI 1548681091

    RCHP-Ottumwa Holdings Inc

    CMS ownership
  • Essent PRMC LP

    dba Paris Regional Medical Center

    • General Acute Care Hospital
    • Paris, TX
    • NPI 1063411767

    RCHP LLC, Regionalcare Hospital Partners LLC

    CMS ownership
  • Essent PRMC LP

    dba Paris Regional Medical Center

    • Rehabilitation Hospital Unit
    • Paris, TX
    • NPI 1710986385

    RCHP LLC, Regionalcare Hospital Partners LLC

    CMS ownership
  • Essent PRMC LP

    dba Paris Health Clinic

    • Rural Health Clinic/Center
    • Paris, TX
    • NPI 1861490054

    RCHP LLC, Regionalcare Hospital Partners LLC

    CMS ownership
  • PRMC Healthcare Group Inc

    dba Clarksville Family Clinic

    • Rural Health Clinic/Center
    • Clarksville, TX
    • NPI 1841808763

    RCHP LLC, Regionalcare Hospital Partners LLC

    CMS ownership
  • RCHP - Florence LLC

    dba Shoals Hospital

    • Psychiatric Hospital Unit
    • Muscle Shoals, AL
    • NPI 1376854208

    RCHP LLC, Regionalcare Hospital Partners LLC

    CMS ownership
  • RCHP - Florence LLC

    dba North Alabama Medical Center

    • General Acute Care Hospital
    • Florence, AL
    • NPI 1477874337

    RCHP LLC, Regionalcare Hospital Partners LLC

    CMS ownership
View all 19

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1962023663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N 3RD ST",
            "city": "EDDYVILLE",
            "state": "IA",
            "postal_code": "525537709",
            "telephone_number": "641-969-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTUMWA HEALTH GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-04",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Eddyville Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Eddyville Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eddyville, IA

Sources for this page

Verify at the official NPI Registry.