MEDICAL CLINIC LLC
NPI 1124218706
Family Medicine in Hamburg, IA

Active since July 30, 2007CLIA 16D0385985 · Accreditation
1219 MAIN ST, HAMBURG, IA 51640(712) 382-2626 Get Directions Write a Review

NPPES record last updated: August 12, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 12, 2024, Jul 23, 2024 (2 updates tracked since 2024).

About Medical Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEDICAL CLINIC LLC (NPI 1124218706), doing business as Medical Clinic P.c., is a healthcare organization registered as a family medicine in Hamburg, Iowa and active in the NPI registry since July 2007. The organization holds an CLIA Accreditation certificate valid through June 23, 2028 and lists Cristin A Hendrickson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1124218706
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMEDICAL CLINIC LLC
Location Address1219 MAIN STHamburg, IA 51640-1300
Mailing Address1219 Main StHamburg, IA 51640-1300 · (712) 382-2626
Organization SubpartNo
Authorized OfficialCristin A HendricksonCeo · (712) 382-1515
Enumeration DateJuly 30, 2007
Last NPPES UpdateAugust 12, 20242 updates tracked since enumeration
NPPES CertifiedAugust 12, 2024
✔ NPI 1124218706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1219 MAIN ST, Hamburg, IA 51640

Other Names 1

Former Legal Business NameMedical Clinic P.c.

Other Identifiers 1

Medicaid0018507IA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Medical Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Medical Clinic LLC, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 7 within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Nurse Practitioner
NPI 1962180224
1219 MAIN ST
Hamburg, IA 51640
(712) 382-2626
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1235963786
1219 MAIN STREET
Hamburg, IA 51640
(712) 382-2626
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1083443527
1219 MAIN STREET
Hamburg, IA 51640
(712) 382-2626
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1427164789
1219 MAIN ST
Hamburg, IA 51640
(712) 382-2626
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1710559083
1219 MAIN ST
Hamburg, IA 51640
(712) 382-2626
✔ PECOS✔ Accepts MedicareSame address
General Practice
NPI 1285606731
1219 MAIN ST
Hamburg, IA 51640
(712) 382-2626
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1710655352
313 MAIN ST
Sidney, IA 51652
(712) 374-2649
✔ PECOS✔ Accepts Medicare9.4 mi
Nurse Practitioner
NPI 1225872914
26136 US HIGHWAY 59
Fairfax, MO 64446
(660) 686-2211
✔ PECOS✔ Accepts Medicare22 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 16D0385985

Medical Clinic, LLC · Hamburg, IA
Active · expires Jun 23, 2028
CLIA Number16D0385985
Laboratory TypeRural Health Clinic
Certificate Effective DateJune 24, 2026
Certificate Expiration DateJune 23, 2028
Laboratory DirectorKelli Woltemath
Laboratory Phone(712) 382-2626
Laboratory LocationMedical Clinic, LLC1219 Main Street, Hamburg, IA 51640
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Medical Clinic LLC's NPI number?

The NPI number for Medical Clinic LLC is 1124218706. It was assigned to this organization in the NPPES registry on July 30, 2007. The provider was formerly known as Medical Clinic P.C..

Where is Medical Clinic LLC located?

Medical Clinic LLC is located at 1219 Main St, Hamburg, IA 51640. The listed phone number is (712) 382-2626.

What is Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Medical Clinic LLC enrolled in Medicare?

Yes. Medical Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Medical Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 3 Medicare specialties reassign their Medicare billing to Medical Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (6), Family Practice (1) and General Practice (1). Of these, 6 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Medical Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 16D0385985) is associated with this NPI, valid through June 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Medical Clinic LLC was last updated on August 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.