NPIMap

Organization Active NPI

Ellsworth Municipal Hospital

Doing business as Iowa Falls Clinic

  • Family Medicine Physician
  • Iowa Falls, IA
National Provider Identifier
1043229735
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ELLSWORTH MUNICIPAL HOSPITAL
Practice address
920 South Oak St
Suite 1
Iowa Falls, IA 50126-9506
Phone
(641) 648-7100
Fax
(641) 648-7095
NPI assigned
Aug 5, 2006
Last updated
Nov 25, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ELLSWORTH MUNICIPAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Authorized official

Name
George Von Mock
Title
Ceo
Phone
(641) 648-7010

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Physician Assistant 363A00000X NU
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

920 South Oak St
Suite 1
Iowa Falls, IA 50126-9506

Mailing address

920 South Oak St
Suite 1
Iowa Falls, IA 50126-9506
Phone (641) 648-7101

Other identifiers 1

IdentifierTypeStateIssuer
421467712OtherIATAX ID

Other names 1

  • Iowa Falls Clinic Other name

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address HIM@elmhn.cernerdirect.com Direct
Direct Messaging Address HIM@elmhn.cernerdirect.com Direct
Direct Messaging Address HIM@elmhn.cernerdirect.com Direct ELLSWORTH MUNICIPAL HOSPITAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040212000269 IA Part B Supplier - Clinic/Group Practice 2668366311 Receives reassigned benefits from 39 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ackley, IA; Iowa Falls, IA; Zearing, IA

Other NPIs on the same Medicare enrollment 9

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0382813Iowa Falls Clinic920 S Oak Street, Suite 1, Iowa Falls, IA 50126Certificate of waiverApr 1, 2028

National Provider Directory

National Provider Directory
Tax ID family
Lance F Yeoman DO6 organizations share this tax ID, including this one
Part of
Lance F Yeoman DO

Other organizations with this tax ID 5

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

Locations

920 S Oak St
Ste 1
Iowa Falls, IA 50126
Phone (641) 648-4233

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1043229735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 SOUTH OAK ST",
            "address_2": "SUITE 1",
            "city": "IOWA FALLS",
            "state": "IA",
            "postal_code": "501269506",
            "telephone_number": "641-648-7101",
            "fax_number": "641-648-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 SOUTH OAK ST",
            "address_2": "SUITE 1",
            "city": "IOWA FALLS",
            "state": "IA",
            "postal_code": "501269506",
            "telephone_number": "641-648-7100",
            "fax_number": "641-648-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH MUNICIPAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLSWORTH MUNICIPAL HOSPITAL",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "VON MOCK",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-648-7010"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "421467712",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "HIM@elmhn.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Hansen Family Hospital Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "920 S Oak St",
            "city": "Iowa Falls",
            "state": "IA",
            "country_code": "US",
            "postal_code": "501269506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "HIM@elmhn.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Hansen Family Hospital Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "920 SOUTH OAK ST",
            "address_2": "SUITE 1",
            "city": "Iowa Falls",
            "state": "IA",
            "country_code": "US",
            "postal_code": "501269506",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "HIM@elmhn.cernerdirect.com",
            "affiliation": "Y",
            "endpointDescription": "Hansen Family HospitalDirect Email Address",
            "affiliationName": "ELLSWORTH MUNICIPAL HOSPITAL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "920 SOUTH OAK ST",
            "address_2": "SUITE 1",
            "city": "Iowa Falls",
            "state": "IA",
            "country_code": "US",
            "postal_code": "501269506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "IOWA FALLS CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IOWA FALLS CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Iowa Falls Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Iowa Falls, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.