NPIMap

Organization Active NPI

Greene County Medical Center

  • Critical Access Hospital
  • Jefferson, IA
National Provider Identifier
1083654883
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
GREENE COUNTY MEDICAL CENTER
Practice address
1000 W Lincoln Way
Jefferson, IA 50129-1645
Phone
(515) 386-2114
Fax
(515) 386-3695
NPI assigned
Jun 8, 2006
Last updated
Jan 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Authorized official

Name
Chad H Butterfield
Title
Ceo
Phone
(515) 386-2114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

1000 W Lincoln Way
Jefferson, IA 50129-1645

Mailing address

1000 W Lincoln Way
Jefferson, IA 50129-1645
Phone (515) 386-2114

Medicare participation

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

Enrollment records 2

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
O20071121000309 IA Part A Provider - Critical Access Hospital 0143208595 Receives reassigned benefits from 13 practitioners
Practice locations: Jefferson, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083654883. Details of each certification follow.

Hospital certification: CCN 161325

Legal name
GREENE COUNTY MEDICAL CENTER
Doing business as
GREENE COUNTY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 1, 2001
Last certification
Jul 12, 2023
Beds
25
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
1000 W Lincoln Way
Jefferson, IA 50129-1645

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 10

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Greene County Medical CenterCCN 161325 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Medical Imaging PC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Douglas E Hawn Individual Corporate Officer Jan 23, 2020
Corporate Director Jan 1, 2009
Central Iowa Hospital Corporation Organization, Des Moines, IA Corporation, Non-profit Operational/Managerial Control Jul 1, 2011
Angela S Jewett Individual Corporate Director Nov 23, 2021
Mark T Wall Individual Contracted Managing EmployeeCfo Feb 28, 2022
Corporate OfficerCfo Feb 28, 2022
Operational/Managerial ControlCfo Feb 28, 2022
Rochelle L Guess Individual W-2 Managing EmployeePresident of Medical Staff Dec 28, 2021
Operational/Managerial ControlPresident of Medical Staff Dec 28, 2021
Doug Carman Individual Corporate Director Mar 24, 2022
Kim J Bates Individual Corporate Director Jan 22, 2010
William D Raney Individual Corporate Officer Dec 21, 2021
Corporate Director Mar 21, 2013
Katherine B Neese Individual Corporate Director Jan 23, 2020
James T Schleisman Individual Corporate Officer Jan 1, 1997
Corporate Director Jul 24, 1995
Chad H Butterfield Individual Contracted Managing EmployeeCeo Jul 27, 2020
Corporate OfficerCeo Jul 27, 2020
Operational/Managerial ControlCeo Jul 27, 2020

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 22

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 22

Practitioners & affiliated clinicians

Practitioners 13

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 13

Affiliated clinicians 72

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 72

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": "1641945600000",
    "number": "1083654883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W LINCOLN WAY",
            "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 LINCOLN WAY",
            "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": "2006-06-08",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "BUTTERFIELD",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-386-2114"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, IA

Sources for this page

Verify at the official NPI Registry.