NPIMap

Organization Active NPI

Greene County Medical Center

Doing business as Greene County Medical Center HHA

  • Home Health Agency
  • Jefferson, IA
National Provider Identifier
1063592582
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GREENE COUNTY MEDICAL CENTER
Doing business as
Greene County Medical Center HHA
Practice address
1000 W Lincolnway St
Jefferson, IA 50129-1645
Phone
(515) 386-2114
Fax
(515) 386-3695
NPI assigned
Oct 17, 2006
Last updated
Jun 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Authorized official

Name
Mr. Mark A Vanderlinden
Title
Cfo
Phone
(515) 386-2114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1000 W Lincolnway St
Jefferson, IA 50129-1645

Mailing address

1000 W Lincolnway St
Jefferson, IA 50129-1645
Phone (515) 386-2114

Other identifiers 1

IdentifierTypeStateIssuer
670927MedicaidIA

Other names 1

  • Greene County Medical Center HHA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040712000717 IA Part B Supplier - Clinic/Group Practice 0143208595 Receives reassigned benefits from 30 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jefferson, IA

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1063592582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W LINCOLNWAY ST",
            "city": "JEFFERSON",
            "state": "IA",
            "postal_code": "501291645",
            "telephone_number": "515-386-2114",
            "fax_number": "515-386-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W LINCOLNWAY ST",
            "city": "JEFFERSON",
            "state": "IA",
            "postal_code": "501291645",
            "telephone_number": "515-386-2114",
            "fax_number": "515-386-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "VANDERLINDEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "515-386-2114",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "670927",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greene County Medical Center HHA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.