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Organization Active NPI

Madison County Memorial Hospital

Doing business as Madison County Health Care System

  • Medicare Defined Swing Bed Hospital Unit
  • Winterset, IA
National Provider Identifier
1194880112
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
MADISON COUNTY MEMORIAL HOSPITAL
Doing business as
Madison County Health Care System
Practice address
300 W Hutchings St
Winterset, IA 50273-2104
Phone
(515) 462-2373
Fax
(515) 462-5213
NPI assigned
Dec 27, 2006
Last updated
Aug 22, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
MADISON COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Authorized official

Name
Mrs. Marcia L Hendricks
Title
Ceo
Phone
(515) 462-2373

Specialties & licenses 1

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

Addresses

Primary practice location

300 W Hutchings St
Winterset, IA 50273-2104

Mailing address

300 W Hutchings St
Winterset, IA 50273-2104
Phone (515) 462-2373

Other names 1

  • Madison County Health Care System Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110928000095 IA Part A Provider - Critical Access Hospital 6002727179 Practice locations: Winterset, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194880112. Details of each certification follow.

Hospital certification: CCN 16Z326

Legal name
MADISON COUNTY MEMORIAL HOSPITAL
Doing business as
MADISON COUNTY HEALTH CARE SYSTEM
Organization structure
OtherNon-profit
Enrollment address
300 W Hutchings St
Winterset, IA 50273-2104
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Cooper Ste6 organizations share this tax ID, including this one
Part of
Cooper Ste

Other organizations with this tax ID 5

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

Locations

300 W Hutchings St
#100
Winterset, IA 50273
Phone (515) 462-2373

901 S 4th Ave
Ste A
Winterset, IA 50273
Phone 5154622373605

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Jared McDonald Individual Corporate Officer Sep 26, 2019
Corporate Director May 28, 2015
Sarah C. Nigg Individual Corporate Director May 9, 2024
Brian K Gibson Individual Corporate Officer Dec 1, 2022
Corporate Director Dec 14, 2021
Mercy Health Network Inc Organization, Clive, IA Corporation, Management services company, Non-profit Operational/Managerial Control Nov 1, 2012
Julie R Plant Individual Corporate Director Jan 22, 2026
Jacque Mohs Individual Corporate Officer Jan 1, 2021
Corporate Director Jul 23, 2015
Sharon Carlson Individual Corporate Director Jan 26, 2017
Audra C Ford Individual Corporate OfficerCfo Sep 2, 2024
W-2 Managing EmployeeCfo Sep 2, 2024
Operational/Managerial ControlCfo Sep 2, 2024
Gary R Van Dyke Individual Corporate Director Jan 1, 2025
Marcia L. Hendricks Individual Contracted Managing EmployeeCeo Sep 8, 2003
Corporate OfficerCeo Jun 23, 2016
Operational/Managerial ControlCeo Sep 8, 2003
Kevin V Deregnier Individual W-2 Managing EmployeeChief of Staff Nov 14, 2025
Operational/Managerial ControlChief of Staff Nov 14, 2025

Owners & managing parties with NPI records 1

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

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 65

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.

View all 65

Affiliated clinicians 4

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": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471824000000",
    "number": "1194880112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HUTCHINGS ST",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "502732104",
            "telephone_number": "515-462-2373",
            "fax_number": "515-462-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HUTCHINGS ST",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "502732104",
            "telephone_number": "515-462-2373",
            "fax_number": "515-462-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MADISON COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2006-12-27",
        "last_updated": "2016-08-22",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-462-2373",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison County Health Care System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winterset, IA

Sources for this page

Verify at the official NPI Registry.