NPIMap

Organization Active NPI

Clarke County Public Hospital

Doing business as Clarke County Hospital

  • Emergency Medicine Physician
  • Osceola, IA
National Provider Identifier
1023045804
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CLARKE COUNTY PUBLIC HOSPITAL
Doing business as
Clarke County Hospital
Practice address
800 S Fillmore St
Osceola, IA 50213-1694
Phone
(641) 342-2184
Fax
(641) 342-5318
NPI assigned
Jun 27, 2006
Last updated
Feb 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
CLARKE COUNTY PUBLIC HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Authorized official

Name
Mrs. Susan Daniels
Title
Cfo
Phone
(641) 342-2184

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Registered Dietitian 133V00000X
Wound Care Registered Nurse 163WW0000X
Emergency Medicine Physician 207P00000X Primary
Family Medicine Physician 207Q00000X
Gastroenterology Physician 207RG0100X
Hematology & Oncology Physician 207RH0003X
Orthopaedic Surgery Physician 207X00000X
Otolaryngology Physician 207Y00000X
Psychiatry Physician 2084P0800X
Surgery Physician 208600000X
Hospitalist Physician 208M00000X
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Certified Registered Nurse Anesthetist 367500000X

Addresses

Primary practice location

800 S Fillmore St
Osceola, IA 50213-1694

Mailing address

800 S Fillmore St
Osceola, IA 50213-1694
Phone (641) 342-2184

Other identifiers 1

IdentifierTypeStateIssuer
33203OtherWELLMARK CRNA #

Other names 1

  • Clarke County Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040224000636 IA Part B Supplier - Clinic/Group Practice 1951219328 Receives reassigned benefits from 68 practitioners
Practice locations: Osceola, IA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Wolfe Pet

Locations

800 S Fillmore St
Ste Ab
Osceola, IA 50213

800 S Fillmore St
Ste B
Osceola, IA 50213

800 S Fillmore St
Ste C
Osceola, IA 50213

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 82

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 82

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1023045804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S FILLMORE ST",
            "city": "OSCEOLA",
            "state": "IA",
            "postal_code": "502131694",
            "telephone_number": "641-342-2184",
            "fax_number": "641-342-5318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S FILLMORE ST",
            "city": "OSCEOLA",
            "state": "IA",
            "postal_code": "502131694",
            "telephone_number": "641-342-2184",
            "fax_number": "641-342-5318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKE COUNTY PUBLIC HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLARKE COUNTY PUBLIC HOSPITAL",
        "enumeration_date": "2006-06-27",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "641-342-2184",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK CRNA #",
            "identifier": "33203",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarke County Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clarke County Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Osceola, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.