Humboldt County Memorial Hospital

Organization Active NPI Emergency Medicine Physician · Humboldt, IA

NPI 1043395247 · NPPES record last updated Apr 5, 2019

Key facts

NPI
1043395247
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Medicine Physician 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
Organization subpart
Yes
Parent organization (as reported)
HUMBOLDT COUNTY MEMORIAL HOSPITAL

Authorized official

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

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 3

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

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 53

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in IA, IL, OR

Medicare enrollment records

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

National Provider Directory

Part of
Humboldt Hosp ER Phys

Locations

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YM0800X
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207P00000X Yes
Family Medicine Physician
Group: 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

Other identifiers

IdentifierTypeStateIssuer
0023713MedicaidIA
02371OtherIABLUE CROSS PROF

Other providers in Humboldt, IA

All providers in Humboldt, IA · Emergency Medicine Physician in Iowa

Sources for this page

Verify at the official NPI Registry.