Audubon County Memorial Hospital

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

AUDUBON COUNTY MEMORIAL HOSPITAL

Doing business as

Exira Medical Clinic

Practice address

107 S Jefferson St
Exira, IA 50076-7726

Phone

(712) 268-5348

Fax

(712) 268-2145

NPI assigned

Jul 17, 2008

Last updated

Aug 26, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

AUDUBON COUNTY MEMORIAL HOSPITALAs reported in NPPES

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

Authorized official

Name

Mr. Thomas G Smith

Title

Cfo/Administrator

Phone

(712) 563-5301

Specialties & licenses 1

Addresses

Other names 1

• Exira Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Audubon County Memorial Hospital

  • Emergency Medicine Physician
  • Audubon, IA
  • NPI 1730153420

  O20040312001260

  Same enrollment

Part of

Audubon Co Mem Hospital

Interoperability endpoints

• FHIR API: https://myepicapps.uihealthcare.org/FHIRProxy/api/FHIR/R4/

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1184888265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 PACIFIC AVE",
            "city": "AUDUBON",
            "state": "IA",
            "postal_code": "500251056",
            "telephone_number": "712-563-2611",
            "fax_number": "712-563-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S JEFFERSON ST",
            "city": "EXIRA",
            "state": "IA",
            "postal_code": "500767726",
            "telephone_number": "712-268-5348",
            "fax_number": "712-268-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUDUBON COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AUDUBON COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CFO/ADMINISTRATOR",
        "authorized_official_telephone_number": "712-563-5301",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Exira Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Audubon County Memorial Hospital
• James D Brokke, D.O.
• Exira Care Center Corporation (Exira Care Center)
• Exira Community School Ditrict
• Exira Family Medicine Clinic, LLC

• General Practice Physician in Exira, IA
• Providers in Exira, IA by specialty
• General Practice Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.