NPIMap

Organization Active NPI

Grundy County Memorial Hospital

Doing business as GCMH Professional Services

  • Emergency Medicine Physician
  • Grundy Center, IA
National Provider Identifier
1114012085
Registry record updated Mar 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
GRUNDY COUNTY MEMORIAL HOSPITAL
Doing business as
GCMH Professional Services
Practice address
201 E J Ave
Grundy Center, IA 50638-2096
Phone
(319) 824-5421
Fax
(319) 824-6291
NPI assigned
Oct 4, 2006
Last updated
Mar 7, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
GRUNDY COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2013

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

Authorized official

Name
Lisa A. Zinkula
Title
Cfo
Phone
(319) 824-5082

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Certified Registered Nurse Anesthetist 367500000X NU
Emergency Medicine Physician 207P00000X NU Primary
Orthopaedic Surgery Physician 207X00000X NU

Addresses

Primary practice location

201 E J Ave
Grundy Center, IA 50638-2096

Mailing address

201 E J Ave
Grundy Center, IA 50638-2096
Phone (319) 824-5421

Other names 1

  • GCMH Professional Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000174 IA Part B Supplier - Clinic/Group Practice 6406766435 Receives reassigned benefits from 64 practitioners
Practice locations: Grundy Center, IA

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Part of
Grundy County Mem Hospital

Locations

2313 15th Ave
Eldora, IA 50627
Phone (641) 858-5422

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
CreeksideGrundy Center, IA, CCN 165623 Skilled nursing facility Adp of the SNF Jan 1, 2025

Owned or controlled facilities with NPI records 1

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

  • Creekside, Inc

    dba Creekside

    • Nursing Facility/Intermediate Care Facility
    • Grundy Center, IA
    • NPI 1225546948

    Adp of the SNF

    CMS ownership

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.

Practitioners & affiliated clinicians

Practitioners 67

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 67

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362614400000",
    "number": "1114012085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E J AVE",
            "city": "GRUNDY CENTER",
            "state": "IA",
            "postal_code": "506382096",
            "telephone_number": "319-824-5421",
            "fax_number": "319-824-6291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E J AVE",
            "city": "GRUNDY CENTER",
            "state": "IA",
            "postal_code": "506382096",
            "telephone_number": "319-824-5421",
            "fax_number": "319-824-6291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRUNDY COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRUNDY COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-03-07",
        "status": "A",
        "authorized_official_last_name": "ZINKULA",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "319-824-5082"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GCMH Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grundy Center, IA

Sources for this page

Verify at the official NPI Registry.