Countryside Medical Clinic, LLC
NPI 1396103685 · Primary Care Clinic/Center · Red Oak, IA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Countryside Medical Clinic, LLC is a Primary Care Clinic/Center organization in Red Oak, IA (NPI 1396103685).
Provider details
- NPI number
- 1396103685
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kimberly Rines, Nurse Practitioner(712) 629-0040
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2016-02-02
- Last updated
- 2018-12-12
Frequently asked questions
- What is Countryside Medical Clinic, LLC's NPI number?
- Countryside Medical Clinic, LLC's National Provider Identifier (NPI) is 1396103685, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Countryside Medical Clinic, LLC?
- Countryside Medical Clinic, LLC is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Countryside Medical Clinic, LLC located?
- Countryside Medical Clinic, LLC's practice location on file with NPPES is 1959 200th St, Red Oak, IA 51566-3218.
- What is Countryside Medical Clinic, LLC's phone number?
- The practice phone number listed in the NPPES registry for Countryside Medical Clinic, LLC is (712) 629-0040.
- Does Countryside Medical Clinic, LLC accept Medicare?
- Countryside Medical Clinic, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Countryside Medical Clinic, LLC?
- The authorized official listed on Countryside Medical Clinic, LLC's NPPES record is Kimberly Rines, Nurse Practitioner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Countryside Medical Clinic, LLC's NPI active?
- Yes — Countryside Medical Clinic, LLC's NPI (1396103685) is active in the NPPES registry as of the last update on 2018-12-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.