NPIMap

Organization Active NPI

Humboldt County Memorial Hospital

  • Emergency Medicine Physician
  • Humboldt, IA
National Provider Identifier
1043395247
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
HUMBOLDT COUNTY MEMORIAL HOSPITAL
Practice address
1000 15TH St N
Humboldt, IA 50548-1008
Phone
(515) 332-4200
Fax
(515) 332-4820
NPI assigned
Oct 26, 2006
Last updated
Apr 5, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
HUMBOLDT COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Authorized official

Name
Ms. Michelle Sleiter
Title
Ceo
Phone
(515) 332-4200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X

Addresses

Primary practice location

1000 15TH St N
Humboldt, IA 50548-1008

Mailing address

1000 15TH St N
Humboldt, IA 50548-1008
Phone (515) 332-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL, OR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040310001518 IA Part B Supplier - Clinic/Group Practice 8921997867 Receives reassigned benefits from 48 practitioners
1 other NPI on this enrollment
Practice locations: Humboldt, IA
O20230104001596 IL Part B Supplier - Clinic/Group Practice 8921997867 Receives reassigned benefits from 1 practitioner
Practice locations: Staunton, IL
O20251110002835 OR Part B Supplier - Clinic/Group Practice 8921997867 Receives reassigned benefits from 1 practitioner
Practice locations: Klamath Falls, OR

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Humboldt Hosp ER Phys

Locations

1000 15th St N
Ste B
Humboldt, IA 50548
Phone (515) 332-7555

1000 15th St N
Ste C
Humboldt, IA 50548
Phone (515) 206-7270

Practitioners & affiliated clinicians

Practitioners 52

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 52

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554422400000",
    "number": "1043395247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 15TH ST N",
            "city": "HUMBOLDT",
            "state": "IA",
            "postal_code": "505481008",
            "telephone_number": "515-332-4200",
            "fax_number": "515-332-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 15TH ST N",
            "city": "HUMBOLDT",
            "state": "IA",
            "postal_code": "505481008",
            "telephone_number": "515-332-4200",
            "fax_number": "515-332-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBOLDT COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HUMBOLDT COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2006-10-26",
        "last_updated": "2019-04-05",
        "status": "A",
        "authorized_official_last_name": "SLEITER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-332-4200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humboldt, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.