COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC (NPI# 1295705622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295705622 |
| Entity Type | Organization |
| Organization Name | COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC |
| Other Organization Name | TRI-STATE MEDICAL GROUP INC |
| Practice Address |
345 Polk St Warsaw IL 62379-1033 |
| Mailing Address |
1706 West Agency Road West Burlington IA 52655 |
| Practice Telephone | 2172563013 |
| Practice Fax Number | 3197532301 |
| Mailing Telephone | 3197685858 |
| Mailing Fax Number | 3197532301 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2010-10-19 |
| Authorized Official Name | MRS. APRIL K SCHNEDLER (LEAD BILLING COORDINATOR) |
| Authorized Official Telephone | 3197685809 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0563882 | 05 | |
| IL | BLUE CROSS BLUE SHIELD | 3422957 | 01 |
| MO | 506089424 | 05 |
| Other Name | Type Code |
|---|---|
| Tri-State Medical Group Inc | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265618805 | Community Health Centers of Southeastern Iowa Inc | Clinic/Center | 241 Colonels Drive, Columbus Jct, IA 52738 | 2008-01-14 |
| 1164483491 | Community Health Centers of Southeastern Iowa Inc | Obstetrics & Gynecology | 1425 Morgan St, Keokuk, IA 52632-4027 | 2006-03-28 |
| 1255339750 | Community Health Centers of Southeastern Iowa Inc | Internal Medicine | 1706 West Agency Road, West Burlington, IA 52655 | 2005-07-08 |
| 1558340968 | Community Health Centers of Southeastern Iowa Inc | Family Medicine | 400 N 17th St, Keokuk, IA 52632-3452 | 2006-01-13 |
| 1992784300 | Community Health Centers of Southeastern Iowa Inc | Family Medicine | 951 Broadway St, Hamilton, IL 62341-1436 | 2006-01-13 |
| Street Address |
345 POLK ST |
| City | WARSAW |
| State | IL |
| Zip Code | 62379-1033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922200484 | Warsaw Comm Unit Schl Dist 316 | Local Education Agency (LEA) | 340 S 11th St, Warsaw, IL 62379-1431 | 2007-06-05 |
| 1407074628 | Darlene Louise Young | Private Vehicle | 583 Old Warsaw Rd, Warsaw, IL 62379-3001 | 2007-04-23 |
| 1326082454 | Eliot M Nissenbaum | Internal Medicine | 1102 N County Road 700, Warsaw, IL 62379-3011 | 2006-06-16 |
| 1013410158 | Katherine Anne Phillips | Nurse Practitioner | 1102 N County Road 700, Warsaw, IL 62379-3011 | 2018-03-15 |
| 1952461782 | Annette Yvonne Oetken | Family Medicine | 1102 N County Road 700, Warsaw, IL 62379-3011 | 2006-12-11 |
| 1528143971 | Richard Lewis O'halloran | Urology | 1102 N County Road 700, Warsaw, IL 62379-3011 | 2006-10-26 |
| 1720169899 | Dale D Zimmerman | Family Medicine | 1102 N County Road 700, Warsaw, IL 62379-3011 | 2006-10-17 |
| 1255430104 | Teresa Metzger | Nurse Practitioner | 1102 N County Road 700, Warsaw, IL 62379-3011 | 2006-09-21 |
| 1720186265 | Blessing Corporate Services | Clinic/Center | 1102 N County Road 700, Warsaw, IL 62379-3011 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598364176 | Jace Medical LLC | Durable Medical Equipment & Medical Supplies | 3516 Commerce Dr, Warsaw, IN 46580-3925 | 2020-10-23 |
| 1982202040 | Northern Neck Regional Special Education Program | Spec/Tech, Pathology | 6914 Richmond Rd, Warsaw, VA 22572-3547 | 2020-10-12 |
| 1013523588 | Amy Deion Stitt | Nurse Practitioner | 738 E 200 N, Warsaw, IN 46582-4658 | 2020-09-21 |
| 1689280695 | Nicole Leary | Community Health Worker | 20383 State Route 79, Warsaw, OH 43844-9774 | 2020-09-16 |
| 1871104794 | Legacy Family Chiropractic LLC | Chiropractor | 550 W 300 N, Warsaw, IN 46582-6940 | 2020-08-13 |
| 1437776796 | Brandi K Shepherd | Nurse Practitioner | 1315 Fisher Ave, Warsaw, IN 46580-4810 | 2020-07-02 |
| 1659990174 | Nicole Danielle Wallick | Counselor | 2194 N Pointe Dr, Warsaw, IN 46582-9043 | 2020-04-14 |
| 1710514450 | Chad Goon | Specialist/Technologist | 1216 Meadow Ln, Warsaw, IN 46580-4114 | 2020-03-24 |
| 1992331300 | Sadye Gonnella | Nurse Practitioner | 34 Dunkin Street, Warsaw, NY 14569 | 2020-03-17 |
| 1376177212 | Sarah Lynn Stinson | Counselor | 1016 E Center St, Warsaw, IN 46580-3419 | 2020-03-01 |
| Find all providers in WARSAW | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184165078 | Goshen Medical Center Incorporated | Clinic/Center | 158 Lanefield Rd, Warsaw, NC 28398-8717 | 2017-03-13 |
| 1144538562 | Regional Health Care Clinic | Clinic/Center | 17571 N Dam Access Rd, Warsaw, MO 65355-6396 | 2010-09-20 |
| 1053533539 | Regional Health Care Clinic Inc | Clinic/Center | 17571 N Dam Access Rd, Warsaw, MO 65355-6396 | 2007-05-03 |
| 1346365822 | Goshen Medical Center Incorporated | Clinic/Center | 603 E College St, Warsaw, NC 28398-2104 | 2007-03-21 |
| 1457477820 | Goshen Medical Center Incorporated | Clinic/Center | 113 S Pine St, Warsaw, NC 28398-1924 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417567108 | Pillars Community Health | Clinic/Center | 15w458 91st St, Burr Ridge, IL 60527-6379 | 2020-08-06 |
| 1932724390 | Friend Family Health Center, Inc | Clinic/Center | 7355 S Jeffery Blvd, Chicago, IL 60649-3121 | 2020-06-11 |
| 1871117937 | Primecare Community Health Inc | Clinic/Center | 1431 N Western Ave Ste 101, Chicago, IL 60622-7712 | 2020-06-04 |
| 1639791569 | Community Health Partnership of Illinois | Clinic/Center | 201 W Kenyon Rd Bldg D, Champaign, IL 61820-7892 | 2020-05-14 |
| 1407482219 | Access Community Health Network | Clinic/Center | 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 | 2020-03-13 |
| 1235769704 | Greater Elgin Family Care Center | Clinic/Center | 451 N Mclean Blvd, Elgin, IL 60123-3239 | 2020-01-23 |
| 1710517537 | Greater Elgin Family Care Center Integrated Health Home | Clinic/Center | 1100 Shirley Ave, Streamwood, IL 60107-3068 | 2020-01-21 |
| 1215578109 | Board of Trustees of Southern Illinois University | Clinic/Center | 205 S 24th St Ste 100, Quincy, IL 62301-4446 | 2019-10-02 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.