NPIMap

Organization Active NPI

Mills County

  • Case Management Agency
  • Red Oak, IA
National Provider Identifier
1154469385
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
MILLS COUNTY
Practice address
105 Coolbaugh
Red Oak, IA 51566
Phone
(712) 623-6541
Fax
(712) 623-3677
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sara Ketcham
Title
Administrator
Phone
(712) 623-6541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

105 Coolbaugh
Red Oak, IA 51566

Mailing address

418 Sharp St
Glenwood, IA 51534
Phone (712) 623-6541

Other identifiers 1

IdentifierTypeStateIssuer
0175232MedicaidIA

Other names 1

  • Rolling Prairie Case Mgmt Doing business as

National Provider Directory

National Provider Directory
Tax ID family
County of Mills2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

418 Sharp St
Glenwood, IA 51534

105 E Coolbaugh St
Red Oak, IA 51566
Phone (712) 623-6541

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154469385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 SHARP ST",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "51534",
            "telephone_number": "712-623-6541",
            "fax_number": "712-623-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 COOLBAUGH",
            "city": "RED OAK",
            "state": "IA",
            "postal_code": "51566",
            "telephone_number": "712-623-6541",
            "fax_number": "712-623-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLS COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KETCHAM",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "712-623-6541"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0175232",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rolling Prairie Case Mgmt",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Red Oak, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.