NPIMap

Organization Active NPI

St Luke'S Jones Regional Medical Center

  • Rural Health Clinic/Center
  • Tipton, IA
National Provider Identifier
1194249920
Registry record updated Aug 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ST LUKE'S JONES REGIONAL MEDICAL CENTER
Practice address
1412 Cedar St
Tipton, IA 52772-1100
Phone
(563) 886-2182
Fax
(563) 886-2732
NPI assigned
Aug 2, 2017
Organization subpart
Yes
Parent organization
ST LUKE'S JONES REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 24, 2017

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

Authorized official

Name
Mr. Eric Briesemeister
Title
Ceo
Phone
(319) 462-6131

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

1412 Cedar St
Tipton, IA 52772-1100

Mailing address

1795 Highway 64 E
Anamosa, IA 52205-2112
Phone (319) 462-6131

Other names 2

  • UNITYPOINT HEALTH-FAMILY MEDICINE CLINIC-TIPTON Doing business as
  • UNITYPOINT HEALTH JONES REGIONAL MEDICAL CENTER TIPTON CLINIC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171005001202 IA Part A Provider - Rural Health Clinic 4688572811 Practice locations: Tipton, IA

Rural health clinic certification: CCN 168593

Legal name
ST LUKES JONES REGIONAL MEDICAL CENTER
Doing business as
UNITYPOINT HEALTH-FAMILY MEDICINE CLINIC-TIPTON
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 1, 2017
Last certification
Feb 9, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
1412 Cedar St
Tipton, IA 52772-1100
Related CCNs
161306

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).

National Provider Directory

National Provider Directory
Tax ID family
St Lukes Jones Reg Med CNTR9 organizations share this tax ID, including this one
Part of
St Lukes Jones Reg Med CNTR

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Casey S Greene Individual Corporate Officer Nov 1, 2023
Corporate Director Nov 1, 2023
Clayton T Schuett Individual Contracted Managing EmployeeReg VP/Med Dir & Medical Director Nov 1, 2017
Operational/Managerial ControlReg VP/Med Dir & Medical Director Nov 1, 2017
Philip Lee Hanna Individual Corporate DirectorDirector Feb 7, 2022
Aimee Hospodarsky Individual Corporate Director Feb 6, 2023
Shaun Lambertsen Individual Corporate Director Jan 1, 2025
Katherine Read Individual Contracted Managing EmployeeRegional VP/Clinic Operations Jun 1, 2024
Operational/Managerial Control Jun 1, 2024
Rachel a Vonbehren Individual W-2 Managing EmployeeDirector of Support Services Jun 10, 2000
Operational/Managerial ControlCompliance & Business Serv Director Jun 10, 2000
Eric G Briesemeister Individual Contracted Managing EmployeeCeo Oct 5, 2009
Corporate OfficerCeo Oct 5, 2009
Corporate DirectorCeo Oct 5, 2009
Operational/Managerial ControlCeo Oct 5, 2009
Iowa Health System Organization, West Des Moines, IA Non-profit Operational/Managerial Control Jan 1, 1995
Lucas N Hicks Individual Corporate Director Dec 4, 2023
St Luke'S Healthcare Organization, Cedar Rapids, IA Non-profit Operational/Managerial Control Oct 22, 1998
Angela M Greif Individual Contracted Managing EmployeeMedical Staff President Jan 1, 2021
Janine Sulzner Individual Corporate Director Feb 6, 2023
David Kehoe Individual Corporate Officer Feb 6, 2023
Corporate Director Jun 2, 2020
Jennifer Lange Individual W-2 Managing EmployeeClinic Manager Nov 1, 2017
Operational/Managerial ControlClinic Manager Nov 1, 2017

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Jones Regional Medical CenterAnamosa, IA, CCN 16Z306 Hospital 5% Or Greater Direct Ownership Interest (5%)
Operational/Managerial Control		 Oct 1, 2007
Oct 3, 2007

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 75

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

View all 75

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

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
16D0387780Unitypoint Health1412 Cedar Street, Tipton, IA 52772Provider-performed microscopyFeb 29, 2028

NPI Registry JSON

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503532800000",
    "number": "1194249920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 HIGHWAY 64 E",
            "city": "ANAMOSA",
            "state": "IA",
            "postal_code": "522052112",
            "telephone_number": "319-462-6131",
            "fax_number": "319-481-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 CEDAR ST",
            "city": "TIPTON",
            "state": "IA",
            "postal_code": "527721100",
            "telephone_number": "563-886-2182",
            "fax_number": "563-886-2732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKE'S JONES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST LUKE'S JONES REGIONAL MEDICAL CENTER",
        "enumeration_date": "2017-08-02",
        "last_updated": "2017-08-24",
        "status": "A",
        "authorized_official_last_name": "BRIESEMEISTER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-462-6131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UNITYPOINT HEALTH-FAMILY MEDICINE CLINIC-TIPTON",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UNITYPOINT HEALTH JONES REGIONAL MEDICAL CENTER TIPTON CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tipton, IA

Sources for this page

Verify at the official NPI Registry.