NPIMap

Organization Active NPI

Lucas County Heatlh Center

Doing business as Lucas County Health Center Surgical Group

  • Surgery Physician
  • Chariton, IA
National Provider Identifier
1003210824
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
LUCAS COUNTY HEATLH CENTER
Doing business as
Lucas County Health Center Surgical Group
Practice address
1200 N 7TH St
Chariton, IA 50049-1210
Phone
(641) 774-3000
NPI assigned
Oct 22, 2014
Last updated
Nov 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brian S Sims
Title
Ceo
Phone
(641) 774-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1200 N 7TH St
Chariton, IA 50049-1210

Mailing address

1200 N 7TH St
Chariton, IA 50049-1210
Phone (641) 774-3000

Other identifiers 1

IdentifierTypeStateIssuer
I6951OtherIAMEDICARE PTAN

Other names 1

  • Lucas County Health Center Surgical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317001356 IA Part B Supplier - Clinic/Group Practice 8921916792 Receives reassigned benefits from 42 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chariton, IA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lucas County Health Center10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1003210824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N 7TH ST",
            "city": "CHARITON",
            "state": "IA",
            "postal_code": "500491210",
            "telephone_number": "641-774-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N 7TH ST",
            "city": "CHARITON",
            "state": "IA",
            "postal_code": "500491210",
            "telephone_number": "641-774-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCAS COUNTY HEATLH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-774-3000"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "I6951",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lucas County Health Center Surgical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chariton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.