NPIMap

Organization Active NPI

Cass County Memorial Hospital

  • Optometrist
  • Atlantic, IA
National Provider Identifier
1043747280
Registry record updated Jul 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CASS COUNTY MEMORIAL HOSPITAL
Practice address
1501 E 10TH St Ste 200
Atlantic, IA 50022-1936
Phone
(712) 243-7540
Fax
(712) 243-7544
NPI assigned
May 18, 2017
Organization subpart
Yes
Parent organization
CASS COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2017

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

Authorized official

Name
Ms. Abbey L Stangl
Title
Cfo
Phone
(712) 243-7804

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1501 E 10TH St Ste 200
Atlantic, IA 50022-1936

Mailing address

1501 E 10TH St
Atlantic, IA 50022-1936
Phone (712) 243-3250

Other names 1

  • EYE ASSOCIATES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170818001610 IA DME Supplier - Physician - OptometristDME Supplier - Optician 5294634994 Practice locations: Atlantic, IA
O20170831003371 IA Part B Supplier - Clinic/Group Practice 5294634994 Receives reassigned benefits from 1 practitioner
Practice locations: Atlantic, IA

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Coss County Memorial Ho7 organizations share this tax ID, including this one
Part of
Coss County Memorial Ho

Other organizations with this tax ID 6

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

Locations

1501 E 7th St
Atlantic, IA 50022

1501 E 10th St
Ste 200
Atlantic, IA 50022
Phone (712) 243-7540

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Griswold Medical CenterGriswold, IA, CCN 168525 Rural health clinic Operational/Managerial Control May 25, 2007
Massena Medical CenterMassena, IA, CCN 168524 Rural health clinic Operational/Managerial Control May 25, 2007
Anita Medical CenterAnita, IA, CCN 168526 Rural health clinic Operational/Managerial Control May 25, 2007

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501200000000",
    "number": "1043747280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E 10TH ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221936",
            "telephone_number": "712-243-3250",
            "fax_number": "712-243-7587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E 10TH ST STE 200",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221936",
            "telephone_number": "712-243-7540",
            "fax_number": "712-243-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASS COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CASS COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2017-05-18",
        "last_updated": "2017-07-28",
        "status": "A",
        "authorized_official_last_name": "STANGL",
        "authorized_official_first_name": "ABBEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "712-243-7804",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EYE ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EYE ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlantic, IA

Sources for this page

Verify at the official NPI Registry.