NPIMap

Organization Active NPI

Decatur County Hospital

  • Critical Access Hospital
  • Leon, IA
National Provider Identifier
1144209255
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
270089H Issued in IA
Legal business name
DECATUR COUNTY HOSPITAL
Practice address
1405 NW Church St
Leon, IA 50144-1267
Phone
(641) 446-4871
NPI assigned
Jan 17, 2006
Last updated
Mar 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Authorized official

Name
Michael Johnston
Title
Ceo
Phone
(641) 446-4871

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 270089H IA Primary

Addresses

Primary practice location

1405 NW Church St
Leon, IA 50144-1267

Mailing address

1405 NW Church St
Leon, IA 50144-1267
Phone (641) 446-4871

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dch@dch.cernerdirect.com Direct

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031210000758 IA Part B Supplier - Clinic/Group Practice 9739085754 Receives reassigned benefits from 72 practitioners
2 other NPIs on this enrollment
Practice locations: Leon, IA
O20071024000076 IA Part A Provider - Critical Access Hospital 9739085754 Receives reassigned benefits from 36 practitioners
Practice locations: Leon, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144209255. Details of each certification follow.

Hospital certification: CCN 161340

Legal name
DECATUR COUNTY HOSPITAL
Doing business as
DECATUR COUNTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 1, 2002
Last certification
May 5, 2022
Beds
25
Ownership / control type
Local
Organization structure
CorporationNon-profit
Enrollment address
1405 NW Church St
Leon, IA 50144-1266

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

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Decatur County HospitalCCN 161340 · 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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Denise Betty Elefson Individual Corporate DirectorBoard Chairperson Jan 1, 2019
Teri J Foster Individual Corporate DirectorBoard Member Feb 27, 2019
Guy Clark Individual Corporate DirectorBoard Secretary Oct 22, 2007
Sheri a Frost Individual Corporate DirectorBoard Vice Chairperson Jan 1, 2017
Mercy Health Network Inc Organization, Clive, IA Operational/Managerial Control Mar 26, 2001
Michael E Johnston Individual Contracted Managing EmployeeChief Executive Officer Nov 24, 2018
Corporate OfficerChief Exectutive Officer Nov 24, 2018
Tara D Spidle Individual Corporate OfficerChief Financial Officer Feb 10, 2010
W-2 Managing EmployeeCfo Feb 10, 2010
Larry L Griffin Individual Corporate DirectorBoard Member Jan 1, 2019

Facilities with the same owner 98

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

View all 98

Practitioners & affiliated clinicians

Practitioners 74

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 74

Affiliated clinicians 50

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

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615248000000",
    "number": "1144209255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 NW CHURCH ST",
            "city": "LEON",
            "state": "IA",
            "postal_code": "501441267",
            "telephone_number": "641-446-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 NW CHURCH ST",
            "city": "LEON",
            "state": "IA",
            "postal_code": "501441267",
            "telephone_number": "641-446-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-446-4871"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IA",
            "license": "270089H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dch@dch.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "DCH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1405 NW Church St",
            "city": "Leon",
            "state": "IA",
            "country_code": "US",
            "postal_code": "501441267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leon, IA

Sources for this page

Verify at the official NPI Registry.