NPIMap

Organization Active NPI

Guttenberg Municipal Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Guttenberg, IA
National Provider Identifier
1184659153
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
GUTTENBERG MUNICIPAL HOSPITAL
Practice address
200 Main Street
Guttenberg, IA 52052
Phone
(536) 252-1121
Fax
(563) 252-3120
NPI assigned
Jul 11, 2006
Last updated
Oct 24, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
GUTTENBERG MUNICIPAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Authorized official

Name
Susan Stagman
Title
Credentialing Specialist
Phone
(563) 252-1121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

200 Main Street
Guttenberg, IA 52052

Mailing address

PO Box 550
Guttenberg, IA 52052-0550
Phone (563) 252-1121

Other identifiers 2

IdentifierTypeStateIssuer
0655647MedicaidIA
66097OtherWELLMARK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070103000393 IA Part A Provider - Critical Access Hospital 6901709476 Receives reassigned benefits from 1 practitioner
Practice locations: Guttenberg, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184659153. Details of each certification follow.

Hospital certification: CCN 16Z312

Legal name
GUTTENBERG MUNICIPAL HOSPITAL
Doing business as
GUTTENBERG MUNICIPAL HOSPITAL
Organization structure
GovernmentNon-profit
Enrollment address
200 Main St
Guttenberg, IA 52052-9108

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Guttenberg Mun Hospital7 organizations share this tax ID, including this one
Part of
Guttenberg Mun Hospital

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
City of Guttenberg Organization, Guttenberg, IA 5% Or Greater Direct Ownership Interest Jan 3, 1966 100%
Janice Lee Andregg Individual Corporate Officer Jan 1, 2016 20%
Robin S Esmann Individual W-2 Managing EmployeeManager Oct 17, 1999
Timothy J Ahlers Individual Contracted Managing EmployeeCeo Apr 22, 2019
Corporate OfficerCeo Apr 22, 2019
Stephanie Radabaugh Individual Corporate Officer Jan 1, 2022
Jill M Knepper Individual Corporate DirectorFinance Manager Jan 3, 2017
William L Allyn Individual Corporate OfficerBoard Trustee Jan 1, 2012 20%
Mercy Health Network Inc Organization, West Des Moines, IA Non-profit Operational/Managerial Control Oct 1, 2017
Austin Coon Individual Corporate Officer Oct 1, 2022
Susan a Osterhaus Individual Corporate Officer Jan 1, 2014 20%

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Cornerstone Family PracticeGuttenberg, IA, CCN 168552 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 1, 2012
Dec 1, 2012
Cornerstone Family PracticeEdgewood, IA, CCN 168553 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 1, 2012
Dec 1, 2012
Cornerstone Family PracticeGarnavillo, IA, CCN 168550 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 1, 2012
Dec 1, 2012

Owned or controlled facilities with NPI records 3

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

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 1

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.

Affiliated clinicians 3

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

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1184659153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "GUTTENBERG",
            "state": "IA",
            "postal_code": "520520550",
            "telephone_number": "563-252-1121",
            "fax_number": "563-252-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAIN STREET",
            "city": "GUTTENBERG",
            "state": "IA",
            "postal_code": "52052",
            "telephone_number": "536-252-1121",
            "fax_number": "563-252-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUTTENBERG MUNICIPAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUTTENBERG MUNICIPAL HOSPITAL",
        "enumeration_date": "2006-07-11",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "STAGMAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "563-252-1121"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0655647",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "66097",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guttenberg, IA

Sources for this page

Verify at the official NPI Registry.