SOUTH CENTRAL IOWA MEDICAL CLINIC
NPI 1104125822
Clinic/Center - Rural Health in Corydon, IA
NPI Status: Active since March 21, 2011
Contact Information
417 S EAST ST
SUITE 100
CORYDON, IA
ZIP 50060
Phone: (641) 872-2063
Fax: (641) 872-2070
- Organization
- Clinic/Center
- Rural Health
- Accepts Insurance
- CLIA Number: 16D0382708
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-28-2026
About SOUTH CENTRAL IOWA MEDICAL CLINIC
This page provides the complete NPI Profile along with additional information for South Central Iowa Medical Clinic, a primary care provider established in Corydon, Iowa operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1104125822 assigned on March 2011. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 8 years ago. South Central Iowa Medical Clinic operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as South Central Iowa Medical Clinic. The authorized official of this NPI record is Daren L Relph (Chief Executive Officer)
- NPI
- 1104125822
- Provider Legal Name
- WAYNE COUNTY HOSPITAL
- Other Organization Name
- SOUTH CENTRAL IOWA MEDICAL CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 417 S EAST ST SUITE 100 CORYDON, IA 50060
- Location Phone
- (641) 872-2063
- Location Fax
- (641) 872-2070
- Mailing Address
- PO BOX 305 CORYDON, IA 50060
- Mailing Phone
- (641) 872-5351
- Mailing Fax
- (641) 872-2070
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-21-2011
- Last Update Date
- 11-21-2017
- Code Navigator
A primary care provider (PCP) like South Central Iowa Medical Clinic sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Rural Health
- Taxonomy Code
- 261QR1300X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 2 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | |
| 3 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
| 4 | 367A00000X | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Complete Silver (QualChoice) - POS
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold (QualChoice) - POS
- Elite Gold (QualChoiceLife) - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Everyday Gold - PPO
- Everyday Gold + Vision + Adult Dental - PPO
- Everyday Silver (QualChoiceLife) - PPO
- Focused Silver - PPO
- Focused Silver + Vision + Adult Dental - PPO
- Standard Expanded Bronze - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Premier Silver - EPO
- Premier Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Clear Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Premier Bronze HSA - EPO
- Premier Bronze HSA + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Central Bronze - HMO
- Central Bronze + Vision + Adult Dental - HMO
- Central Gold - HMO
- Central Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold - PPO
- Elite Gold + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Everyday Gold - PPO
- Everyday Gold + Vision + Adult Dental - PPO
- Focused Silver - PPO
- Focused Silver + Vision + Adult Dental - PPO
- Standard Expanded Bronze - PPO
- Standard Expanded Bronze + Vision + Adult Dental - PPO
- Standard Gold - PPO
- Standard Gold + Vision + Adult Dental - PPO
- Standard Silver - PPO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Medica Insure Bronze $0 Copay PCP Visits - EPO
- Medica Insure Bronze Premier - EPO
- Medica Insure Bronze Share - EPO
- Medica Insure Expanded Bronze Standard - EPO
- Medica Insure Gold $0 Copay PCP Visits - EPO
- Medica Insure Gold Share - EPO
- Medica Insure Gold Standard - EPO
- Medica Insure Silver $0 Copay PCP Visits - EPO
- Medica Insure Silver Share - EPO
- Medica Insure Silver Standard - EPO
- Bronze Classic 4700 (Select) - HMO
- Bronze Classic PCP Saver Plus Rx Copay (Select) - HMO
- Bronze Classic Standard (Choice) - HMO
- Bronze Classic Standard (Select) - HMO
- Gold Classic Standard (Choice) - HMO
- Gold Classic Standard (Select) - HMO
- Secure (Choice) - HMO
- Silver Classic Standard (Choice) - HMO
- Silver Classic Standard (Select) - HMO
- Silver Elite Saver Plus Rx Copay (Select) - HMO
- Silver Simple Diabetes (Choice) - HMO
- Silver Simple Diabetes (Select) - HMO
- Silver Simple PCP Saver (Select) - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic 4700 | MercyOne - EPO
- Bronze Classic Standard - EPO
- Bronze Classic Standard | MercyOne - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Elite + PCP Saver Plus | MercyOne - EPO
- Gold Classic Standard - EPO
- Gold Classic Standard | MercyOne - EPO
- Gold Elite - EPO
- Gold Elite | MercyOne - EPO
- Secure - EPO
- Secure | MercyOne - EPO
- Silver Classic - EPO
- Silver Classic | MercyOne - EPO
- Silver Classic Standard - EPO
- Silver Classic Standard | MercyOne - EPO
- Silver Simple Diabetes - EPO
- Silver Simple Diabetes | MercyOne - EPO
- Silver Simple PCP Saver - EPO
- Silver Simple PCP Saver | MercyOne - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 16D0382708
- Facility Type
- Physician Office
- Certificate Effective Date
- August 29, 2024
- Certificate Expiration Date
- August 28, 2026
- Laboratory Director
- STEPHANIE MAHAN
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to South Central Iowa Medical Clinic after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 0 | 4 | 1 | 2 | 5 | 8 | 2 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 0 | 4 | 2 | 2 | 10 | 8 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 0 + 4 + 2 + 2 + 1 + 0 + 8 + 4 + 24 = 48 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 48 = 2 | 2 | ||||||||
The NPI number 1104125822 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1417932385 | ERNEST MAYTUM BREES P.A.-C Individual | Physician Assistant (Medical) | 417 S EAST ST SUITE #100 CORYDON, IA 50060 (641) 872-2063 |
| 1861586810 | WAYNE FAMILY MEDICAL CENTER, INC. Organization | Family Medicine | 417 S EAST ST SUITE #100 CORYDON, IA 50060 (641) 872-2063 |
| 1669566824 | WAYNE COUNTY HOSPITAL Organization | Clinic/Center (End-Stage Renal Disease (ESRD) Treatment) | 417 S EAST ST CORYDON, IA 50060 (641) 872-2260 |
| 1457421554 | WAYNE COUNTY HOSPITAL Organization | Medicare Defined Swing Bed Unit | 417 S EAST ST CORYDON, IA 50060 (641) 872-2260 |
| 1932325966 | WAYNE COUNTY HOSPITAL Organization | Nurse Anesthetist, Certified Registered | 417 S EAST ST CORYDON, IA 50060 (641) 872-2260 |
| 1740406776 | WAYNE COUNTY HOSPITAL Organization | Family Medicine | 417 S EAST ST CORYDON, IA 50060 (641) 872-2260 |
| 1972894665 | PRAIRIE TRAILS EMERGENCY PHYSICIANS Organization | Emergency Medicine | 417 S EAST ST CORYDON, IA 50060 (641) 872-5240 |
| 1447500418 | LK MADISON MD LLC Organization | Radiology (Diagnostic Radiology) | 417 S EAST ST CORYDON, IA 50060 (641) 872-2260 |
| 1730518150 | SOUTHERN IOWA ORTHOPEDICS LLC Organization | Orthopaedic Surgery | 417 S EAST ST CORYDON, IA 50060 (641) 872-2260 |
| 1174599468 | WAYNE COUNTY HOSPITAL Organization | General Acute Care Hospital (Critical Access) | 417 S EAST ST CORYDON, IA 50060 (641) 872-2260 |
| 1992973382 | WAYNE COUNTY HOSPITAL Organization | Nurse Anesthetist, Certified Registered | 417 S EAST ST CORYDON, IA 50060 (641) 872-2260 |
| 1609174002 | EMMY JO DAVIS CNM Individual | Advanced Practice Midwife | 417 S EAST ST CORYDON, IA 50060 (641) 872-2063 |
| 1174672026 | OJIAKU BALEWA IKEZUAGU MD Individual | Family Medicine | 417 S EAST ST SUITE #100 CORYDON, IA 50060 (641) 872-2063 |
| 1235308958 | WAYNE COUNTY HOSPITAL Organization | Surgery | 417 S EAST ST CORYDON, IA 50060 (641) 872-2260 |
| 1386149680 | RACHEL MCILWAIN Individual | Dietitian, Registered | 417 S EAST ST CORYDON, IA 50060 (641) 872-2260 |
| 1740764661 | CORTNEY SERENE WILSON SA-C Individual | Specialist/Technologist, Other (Surgical Assistant) | 417 S EAST ST CORYDON, IA 50060 (641) 872-2260 |
| 1114902087 | JOEL ALAN WELLS D.O. Individual | Family Medicine | 417 S EAST ST SUITE #100 CORYDON, IA 50060 (641) 872-2063 |
| 1124003009 | AMY LYNN WOOD P.A.-C Individual | Physician Assistant (Medical) | 417 S EAST ST SUITE #100 CORYDON, IA 50060 (641) 872-2063 |
| 1154529535 | JOSHWA L TROMBLEE D.O. Individual | Family Medicine | 417 S EAST ST CORYDON, IA 50060 (641) 872-2063 |
| 1760638852 | SHEHADA M HOMEDAN M.D. Individual | Orthopaedic Surgery | 417 S EAST ST CORYDON, IA 50060 (641) 872-2260 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104125822, enumerated in the NPI registry as an "organization" on March 21, 2011
The provider is located at 417 S East St Suite 100 Corydon, Ia 50060 and the phone number is (641) 872-2063
This medical organization specializes in Clinic/Center with taxonomy code 261QR1300X with a focus in Rural Health
The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 16D0382708 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on March 21, 2011. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.