NPIMap

Organization Active NPI

Ackley Medical Center

Doing business as A department of Ellsworth Hospital

  • Family Nurse Practitioner
  • Ackley, IA
National Provider Identifier
1124307129
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
118827 Issued in IA
Legal business name
ACKLEY MEDICAL CENTER
Doing business as
A department of Ellsworth Hospital
Practice address
1000 10TH Ave
Ackley, IA 50601-1701
Phone
(641) 847-2625
Fax
(641) 847-2509
NPI assigned
Aug 8, 2011
Last updated
Dec 3, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ELLSWORTH MUNICIPAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Authorized official

Name
Darla Sue Nederhoff
Title
Clinic Manager
Phone
(641) 847-2625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 118827 IA Primary

Addresses

Primary practice location

1000 10TH Ave
Ackley, IA 50601-1701

Mailing address

1000 10TH Ave
Ackley, IA 50601-1701

Other names 1

  • A department of Ellsworth Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address HIM@elmhn.cernerdirect.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Ellsworth Municipal Hos6 organizations share this tax ID, including this one
Part of
Ellsworth Municipal Hos

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1124307129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "city": "ACKLEY",
            "state": "IA",
            "postal_code": "506011701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "city": "ACKLEY",
            "state": "IA",
            "postal_code": "506011701",
            "telephone_number": "641-847-2625",
            "fax_number": "641-847-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACKLEY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLSWORTH MUNICIPAL HOSPITAL",
        "enumeration_date": "2011-08-08",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "NEDERHOFF",
        "authorized_official_first_name": "DARLA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "641-847-2625"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "118827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "HIM@elmhn.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Hansen Family Hospital Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "920 S Oak St",
            "city": "Iowa Falls",
            "state": "IA",
            "country_code": "US",
            "postal_code": "501269506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "A department of Ellsworth Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "A department of Ellsworth Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ackley, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.