NPIMap

Organization Active NPI

Delaware County Memorial Hospital

Doing business as Regional Family Health Winthrop

  • Rural Health Clinic/Center
  • Winthrop, IA
National Provider Identifier
1154474609
Registry record updated May 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
280123H Issued in IA
Legal business name
DELAWARE COUNTY MEMORIAL HOSPITAL
Doing business as
Regional Family Health Winthrop
Practice address
345 1St St S
Winthrop, IA 50682-9759
Phone
(319) 935-3343
Fax
(319) 935-3331
NPI assigned
Jan 19, 2007
Last updated
May 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2013

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

Authorized official

Name
Dr. Lon Butikofer, RN, PHD
Title
Ceo
Phone
(563) 927-7308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 280123H IA Primary

Addresses

Primary practice location

345 1St St S
Winthrop, IA 50682-9759

Mailing address

PO Box 359
Manchester, IA 52057-0359
Phone (563) 927-7457

Other names 1

  • Regional Family Health Winthrop Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120416000074 IA Part A Provider - Rural Health Clinic 2062316375 1 other NPI on this enrollment
Practice locations: Winthrop, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154474609. Details of each certification follow.

Rural health clinic certification: CCN 168554

Legal name
DELAWARE COUNTY MEMORIAL HOSPITAL
Doing business as
REGIONAL FAMILY HEALTH WINTHROP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 22, 2013
Last certification
Feb 10, 2021
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Enrollment address
345 1St St S
Winthrop, IA 50682-9759
Related CCNs
161343

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

Other NPIs with the same Medicare PAC ID 10

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.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0384756Regional Family Health Winthrop345 First Street South, Winthrop, IA 50682Certificate of waiverJan 25, 2028

National Provider Directory

National Provider Directory
Tax ID family
Delaware Co Mem Hosp ER12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Kathy Swift Individual Corporate DirectorBoard Member Jan 2, 2023
John Zietlow Individual Corporate DirectorBoard Member Aug 19, 2024 100%
Delaware County Memorial Hospital Organization, Winthrop, IA Operational/Managerial Control Aug 1, 1966 100%
Jane Candace Sherman Individual Corporate DirectorBoard Member Jan 2, 2023
Cathy Lilienthal Individual Corporate DirectorBoard Member Sep 18, 2017
Steve H Palmer Individual Corporate DirectorBoard Member Jun 1, 2004
Danette R Kramer Individual Corporate DirectorCeo Mar 1, 2021 100%
W-2 Managing EmployeeCeo Feb 24, 2017 100%
Joe D Keith Individual Corporate DirectorBoard Member Jan 2, 2001
Chris Tegeler Individual Corporate DirectorBoard Member Jul 1, 2008

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Regional Medical CenterManchester, IA, CCN 161343 Hospital Operational/Managerial Control Aug 28, 2013
Regional Medical CenterManchester, IA, CCN 16Z343 Hospital Operational/Managerial Control Aug 28, 2013
Regional Family Health EdgewoodEdgewood, IA, CCN 168531 Rural health clinic Operational/Managerial Control Jan 1, 1966
Regional Family Health HopkintonHopkinton, IA, CCN 168529 Rural health clinic Operational/Managerial Control Apr 1, 2009
Regional Family Health ManchesterManchester, IA, CCN 168530 Rural health clinic Operational/Managerial Control (100%) Apr 1, 2009
Regional Family Health Strawberry PointStrawberry Point, IA, CCN 168528 Rural health clinic Operational/Managerial Control Apr 1, 2009

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369699200000",
    "number": "1154474609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 359",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520570359",
            "telephone_number": "563-927-7457",
            "fax_number": "563-927-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 1ST ST S",
            "city": "WINTHROP",
            "state": "IA",
            "postal_code": "506829759",
            "telephone_number": "319-935-3343",
            "fax_number": "319-935-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2013-05-28",
        "status": "A",
        "authorized_official_last_name": "BUTIKOFER",
        "authorized_official_first_name": "LON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-927-7308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "RN, PHD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IA",
            "license": "280123H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regional Family Health Winthrop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winthrop, IA

Sources for this page

Verify at the official NPI Registry.