NPIMap

Organization Active NPI

St. Luke's Methodist Hospital

  • Cardiovascular Disease Physician
  • Cedar Rapids, IA
National Provider Identifier
1073553939
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
ST. LUKE'S METHODIST HOSPITAL
Practice address
1026 A Ave NE
Cedar Rapids, IA 52402-5036
Phone
(319) 369-7211
NPI assigned
Jun 8, 2006
Last updated
Jul 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Authorized official

Name
Mr. Milton E Aunan
Title
VP & Cfo
Phone
(319) 369-7094

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Dentist 122300000X NU
Public Health Dentistry 1223D0001X NU
Cardiovascular Disease Physician 207RC0000X NU Primary
Pulmonary Disease Physician 207RP1001X NU
Neurological Surgery Physician 207T00000X NU
Neonatal-Perinatal Medicine Physician 2080N0001X NU

Addresses

Primary practice location

1026 A Ave NE
Cedar Rapids, IA 52402-5036

Mailing address

PO Box 9306
Des Moines, IA 50306-9306
Phone (515) 471-9373

Other identifiers 2

IdentifierTypeStateIssuer
0098098MedicaidIA
C62126OtherIARR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204000942 IA Part B Supplier - Clinic/Group Practice 6608786751 Receives reassigned benefits from 169 practitioners
5 other NPIs on this enrollment
Practice locations: Cedar Rapids, IA; Vinton, IA; Tipton, IA; Independence, IA; Dubuque, IA; Belle Plaine, IA

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 5

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

National Provider Directory

National Provider Directory

Locations

202 10th St SE
Ste 111
Cedar Rapids, IA 52403
Phone (319) 369-7827

202 10th St SE
Ste 285
Cedar Rapids, IA 52403
Phone (319) 369-7816

275 10th St SE
Ste 2210
Cedar Rapids, IA 52403
Phone (319) 368-8346

931 8th Ave SE
Cedar Rapids, IA 52401
Phone (319) 366-8695

Practitioners & affiliated clinicians

Practitioners 215

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 215

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310947200000",
    "number": "1073553939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9306",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503069306",
            "telephone_number": "515-471-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 A AVE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025036",
            "telephone_number": "319-369-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S METHODIST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-07-18",
        "status": "A",
        "authorized_official_last_name": "AUNAN",
        "authorized_official_first_name": "MILTON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP & CFO",
        "authorized_official_telephone_number": "319-369-7094",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0098098",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "C62126",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; 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.