Organization Active NPI

Clarke County

Doing business as Clarke County Public Health

  • Community Health Registered Nurse
  • Osceola, IA
National Provider Identifier
1073939088
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
Legal business name
CLARKE COUNTY
Doing business as
Clarke County Public Health
Practice address
109 S Main St.
Osceola, IA 50213
Phone
(641) 342-3724
Fax
(641) 342-2603
NPI assigned
Mar 14, 2014
Last updated
Mar 15, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CLARKE COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Authorized official

Name
Nicole Jimmerson, RN
Title
Administrator
Phone
(641) 342-3724

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X IA
Public Health or Welfare Agency 251K00000X
Community Health Registered Nurse 163WC1500X Primary

Addresses

Primary practice location

109 S Main St.
Osceola, IA 50213

Mailing address

109 S Main St.
Osceola, IA 50213
Phone (641) 342-3724

Other identifiers 3

IdentifierTypeStateIssuer
67125OtherIABLUE CROSS BLUE SHIELD
0600020MedicaidIA
0671255MedicaidIA

Other names 1

  • Clarke County Public Health Doing business as

National Provider Directory

National Provider Directory
Part of
Clarke County

Locations

109 S Main St
Osceola, IA 50213
Phone (641) 342-3724

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1073939088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S MAIN ST.",
            "city": "OSCEOLA",
            "state": "IA",
            "postal_code": "50213",
            "telephone_number": "641-342-3724",
            "fax_number": "641-342-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S MAIN ST.",
            "city": "OSCEOLA",
            "state": "IA",
            "postal_code": "50213",
            "telephone_number": "641-342-3724",
            "fax_number": "641-342-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKE COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLARKE COUNTY",
        "enumeration_date": "2014-03-14",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "JIMMERSON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "641-342-3724",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "67125",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0600020",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0671255",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarke County Public Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clarke County Public Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Osceola, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.