NPIMap

Organization Active NPI

Alegent Health Community Memorial Hospital of Missouri Valley, Iowa

Doing business as Alegent Health CMH Practitioner Services

  • Family Medicine Physician
  • Missouri Valley, IA
National Provider Identifier
1043356108
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA
Doing business as
Alegent Health CMH Practitioner Services
CHI Health Missouri Valley
Practice address
631 N 8TH St
Missouri Valley, IA 51555-1102
Phone
(712) 642-2784
NPI assigned
Jan 29, 2007
Last updated
Jan 27, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
CHI NEBRASKAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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

Authorized official

Name
Jeanette Wojtalewicz
Title
Cfo
Phone
(402) 343-4323

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Hematology & Oncology Physician 207RH0003X NU

Addresses

Primary practice location

631 N 8TH St
Missouri Valley, IA 51555-1102

Mailing address

631 N 8TH St
Missouri Valley, IA 51555-1102
Phone (712) 642-2784

Other names 2

  • Alegent Health CMH Practitioner Services Doing business as
  • CHI HEALTH MISSOURI VALLEY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040129001183 IA Part B Supplier - Clinic/Group Practice 3678482130 Receives reassigned benefits from 49 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Missouri Valley, IA; Woodbine, IA; Oakland, IA; Logan, IA; Dunlap, 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

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": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580083200000",
    "number": "1043356108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 N 8TH ST",
            "city": "MISSOURI VALLEY",
            "state": "IA",
            "postal_code": "515551102",
            "telephone_number": "712-642-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 N 8TH ST",
            "city": "MISSOURI VALLEY",
            "state": "IA",
            "postal_code": "515551102",
            "telephone_number": "712-642-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHI NEBRASKA",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A",
        "authorized_official_last_name": "WOJTALEWICZ",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "402-343-4323"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alegent Health CMH Practitioner Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alegent Health CMH Practitioner Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHI HEALTH MISSOURI VALLEY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Missouri Valley, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.