JEFFERSON COUNTY HOSPITAL (NPI# 1952409336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952409336 |
Entity Type | Organization |
Organization Name | JEFFERSON COUNTY HOSPITAL |
Other Organization Name | JCH ER SERVICES |
Practice Address |
2000 S Main St Fairfield IA 52556-9572 |
Practice Telephone | 6414724111 |
Practice Fax Number | 6414694375 |
Mailing Telephone | 6414724111 |
Mailing Fax Number | 6414694375 |
Enumeration Date | 2006-09-20 |
Last Update Date | 2020-02-26 |
Authorized Official Name | LARRY DALE PEACH (CFO) |
Authorized Official Telephone | 6414694304 |
Is Organization Subpart | Y |
Parent Organization Name | JEFFERSON COUNTY HOSPITAL |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
03066 | IA | Allopathic & Osteopathic Physicians |
Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
510063H | IA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IA | WELLMARK BC/BS OF IOWA | 07282 | 01 |
IA | 0030031 | 05 | |
IA | WELLMARK BC/BS OF IOWA | 03003 | 01 |
IA | 2151191 | 05 |
Other Name | Type Code |
---|---|
JCH ER SERVICES | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881294536 | Jefferson County Hospital | Clinic/Center | 107 W Harrison St, Richland, IA 52585-9549 | 2020-10-30 |
1225247505 | Jefferson County Hospital | Family Medicine | 870 Main Street, Fayette, MS 39069 | 2007-05-22 |
1871690289 | Jefferson County Hospital | Nursing Facility/Intermediate Care Facility | 400 Highland St, Fairfield, IA 52556-3713 | 2006-09-20 |
1043204555 | Jefferson County Hospital | General Acute Care Hospital | 870 South Main Street, Fayette, MS 39069-0577 | 2005-09-12 |
1386018083 | Jefferson County Hospital | Psychiatric Unit | 870 Main St, Fayette, MS 39069-5695 | 2015-11-18 |
1457728008 | Jefferson County Hospital | Clinic/Center | 2000b S Main St, Fairfield, IA 52556-9572 | 2015-08-31 |
1245643972 | Jefferson County Hospital | Family Medicine | 2000 S Main St, Fairfield, IA 52556-9572 | 2014-06-10 |
1487944856 | Jefferson County Hospital | Pharmacy | 2000 S Main St, Fairfield, IA 52556-9572 | 2011-04-19 |
1972771384 | Jefferson County Hospital | Internal Medicine | 2000 S Main St, Fairfield, IA 52556-9572 | 2008-02-19 |
1780894253 | Jefferson County Hospital | Family Medicine | 870 Main Street, Fayette, MS 39069 | 2007-05-23 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | JEFFERSON COUNTY HOSPITAL | 870 Main St, Fayette, MS 39069-5695 |
Street Address |
2000 S MAIN ST |
City | FAIRFIELD |
State | IA |
Zip Code | 52556-9572 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205945094 | Michael Leon Pogel | Psychiatry & Neurology | 2000 S Main St, Fairfield, IA 52556-9572 | 2006-08-29 |
1528676699 | Dustin C Lane | Pharmacist | 2000 S Main St, Fairfield, IA 52556-9572 | 2020-07-15 |
1891318564 | Taylor Madison Buch | Nurse Practitioner | 2000 S Main St, Fairfield, IA 52556-9572 | 2020-05-28 |
1164990537 | Rachel N Shaw | Occupational Therapy Assistant | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-11-05 |
1982188918 | Suzane Moore | Speech-Language Pathologist | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-09-15 |
1558840553 | Eric Dwayne Held | Physical Therapist | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-08-09 |
1952889628 | Katherine Page Mccloney | Physical Therapist | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-08-03 |
1982106712 | Raelee Lynn Bird | Registered Nurse | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-03-07 |
1013416486 | Karly Matlick | Physical Therapist | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-02-12 |
1255849626 | Jacob Wilson | Physical Therapist | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-01-18 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376175315 | Sarah Jo Chaney | Speech-Language Pathologist | 402 W Burlington Ave, Ste 200, Fairfield, IA 52556 | 2020-02-07 |
1588191290 | Kirk D. Condon | Counselor | 201 South 23rd, Fairfield, IA 52556 | 2017-05-12 |
1740644483 | Felicity Kelly | Acupuncturist | 206 E Burlington Ave #2, Fairfield, IA 52556 | 2016-04-08 |
1275964686 | Donna J Besick | Physical Therapy Assistant | 2000 S. Main St., Fairfield, IA 52556 | 2013-12-11 |
1568894731 | Mary Helen Gartin | Family Medicine | 2000c South Main, Fairfield, IA 52556 | 2013-07-30 |
1699016287 | Sarah Elizabeth Brooks | Acupuncturist | 1825 Okra Blvd, Fairfield, IA 52556 | 2013-03-07 |
1265755631 | Robert H. Schneider | Preventive Medicine | 2100 Mansion Drive, Suite 211 - Inmp, Maharishi Vedic City, IA 52556 | 2010-03-12 |
1033346127 | Madison County Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 1401 S Main St Ste 101, Fairfield, IA 52556 | 2009-06-16 |
1144490178 | Southeastern Renal Dialysis L.c. | Clinic/Center | 2000 A S Main St, Fairfield, IA 52556 | 2008-03-05 |
1497933741 | Rochelle Marie Phelps | Social Worker | 301 W. Burlington, Fairfield, IA 52556 | 2008-02-07 |
Find all providers in zip 52556 |
Taxonomy Code | 207PE0004X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Emergency Medicine |
Specialization | Emergency Medical Services |
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538768239 | Md1, Inc | Emergency Medicine | 55 Lane Rd Ste 300, Fairfield, NJ 07004-1015 | 2020-10-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538140405 | Thomas Joseph Kafka | Emergency Medicine | Regional Medical Center, 709 West Main St., Manchester, IA 52057 | 2005-11-08 |
1477543668 | Michael M Rosenblatt | Emergency Medicine | 1605 Haskell St, Burlington, IA 52601-1406 | 2005-10-27 |
1972098150 | Amanda Sieve | Emergency Medicine | 1200 Pleasant St, Des Moines, IA 50309-1406 | 2018-06-29 |
1508374927 | Kari Lynn Tessum | Emergency Medicine | 802 Kenyon Rd, Fort Dodge, IA 50501-5740 | 2018-01-19 |
1629312723 | Ottumwa Er LLC | Emergency Medicine | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2012-11-15 |
1902162191 | Sarah Wolf Field | Emergency Medicine | 500 E Market St, Iowa City, IA 52245 | 2012-04-02 |
1235422056 | Brian Michael Kuchay | Emergency Medicine | 621 S Illinois Ave, Mason City, IA 50401-5405 | 2011-05-26 |
1497953350 | Heather Noel Stein Poskevich | Emergency Medicine | 1111 6th Ave, Des Moines, IA 50314-2613 | 2007-07-03 |
1689705949 | Jackson County Public Hospital | Emergency Medicine | 700 W Grove St, Maquoketa, IA 52060-2163 | 2007-03-08 |
1164593109 | Buena Vista Regional Medical Center | Emergency Medicine | 1525 W 5th St, Storm Lake, IA 50588-3027 | 2006-11-13 |
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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.