Northwest Iowa Hospital Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

NORTHWEST IOWA HOSPITAL CORPORATION

Doing business as

St Lukes Clinic Network

Practice address

2720 Stone Park Blvd
Room 629
Sioux City, IA 51104-3734

Phone

(712) 279-3380

Fax

(712) 279-7015

NPI assigned

Jun 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark A Johnson

Title

Vice President

Phone

(712) 279-3934

Specialties & licenses 1

Addresses

Other names 1

• St Lukes Clinic Network 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.

• Northwest Iowa Hospital Corporation

  dba St. Luke's Regional Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Sioux City, IA
  • NPI 1215962550

  O20040217000619

  Same enrollment

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194764001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 STONE PARK BLVD",
            "address_2": "ROOM 629",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043734",
            "telephone_number": "712-279-3380",
            "fax_number": "712-279-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 STONE PARK BLVD",
            "address_2": "ROOM 629",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043734",
            "telephone_number": "712-279-3380",
            "fax_number": "712-279-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST IOWA HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "712-279-3934",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Lukes Clinic Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Northside Chiropractic Wellness Center PLC
• Northwest Aea 12
• Northwest Aea 12
• Northwest Iowa Emergency Physicians, PC
• Northwest Iowa Hospital Corporation (St Luke's Regional Medical Center SNF)
• Northwest Iowa Hospital Corporation (St. Luke's Regional Medical Center)
• Northwest Iowa Hospital Corporation (St Lukes Regional Medical Center)
• Northwest Iowa Hospital Corporation
• Northwest Iowa Hospital Corporation (St Lukes Regional Medical Center)
• Northwest Iowa Hospital Corporation (St Lukes Regional Medical Center)

• Internal Medicine Physician in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Internal Medicine Physician in Iowa

• 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.
• 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.