CCMH Medical Clinic – Rural Health Clinic/Center, NPI 1104893700

CCMH Medical Clinic is a healthcare provider. based in Denison, Iowa. specializing in Rural Health Clinic/Center. The NPI Number for CCMH Medical Clinic is 1104893700

Main info

Organization
Name
CCMH Medical Clinic
NPI
1104893700
Phone
(712) 265-2700
Address
100 MEDICAL PKWY
Authorized Official
ERIN C MUCK PRESIDENT/CEO
Enumeration Date
2 March 2006
Last Update Date
5 August 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness80
Years active:20State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for CCMH Medical Clinic

  • 100 MEDICAL PKWY

    STE A

    DENISON, IA 514422614

    Phone: (712) 265-2700

    Fax: (712) 263-1777

    Type: Mailing

  • Crawford County Memorial Hospital, 100, Medical Parkway, Denison, Crawford County, Iowa, 51442, United States

    SUITE A

    DENISON, IA 514422614

    Phone: (712) 265-2700

    Fax: (712) 263-1777

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-07-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20090720000414ORural Health ClinicIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 51442)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for CCMH Medical Clinic?
CCMH Medical Clinic — NPI 1104893700 — is the standard way to identify this listing.
Is CCMH Medical Clinic listed as active for patients and plans?
The listing shows CCMH Medical Clinic as active in the NPI system.
What is CCMH Medical Clinic's primary classification?
Rural Health Clinic/Center is the headline specialty for CCMH Medical Clinic here. Clinical services aligned with this taxonomy classification.
Where should I expect CCMH Medical Clinic on a map?
Expect Denison, Iowa as a primary anchor for CCMH Medical Clinic unless the record lists multiple sites.
Why does CCMH Medical Clinic have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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