NPIMap

Organization Active NPI

Greene County Medical Center

  • Multi-Specialty Clinic/Center
  • Jefferson, IA
National Provider Identifier
1245260652
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
GREENE COUNTY MEDICAL CENTER
Practice address
1000 W Lincoln Way
Jefferson, IA 50129-1645
Phone
(515) 386-2114
Fax
(515) 386-3695
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Authorized official

Name
Chad Herman Butterfield
Title
Ceo
Phone
(515) 386-2114

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X
Multi-Specialty Clinic/Center 261QM1300X Primary
Critical Access Hospital 282NC0060X 370024H IA

Addresses

Primary practice location

1000 W Lincoln Way
Jefferson, IA 50129-1645

Mailing address

1000 W Lincoln Way
Jefferson, IA 50129-1645
Phone (515) 386-2114

Other identifiers 1

IdentifierTypeStateIssuer
0744946MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040712000717 IA Part B Supplier - Clinic/Group Practice 0143208595 Receives reassigned benefits from 30 practitioners
10 other NPIs on this enrollment
Practice locations: Jefferson, IA

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory

Locations

804 Kenyon Rd
Ste 310
Fort Dodge, IA 50501
Phone (515) 302-8700

Practitioners & affiliated clinicians

Practitioners 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1245260652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W LINCOLN WAY",
            "city": "JEFFERSON",
            "state": "IA",
            "postal_code": "501291645",
            "telephone_number": "515-386-2114",
            "fax_number": "515-386-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W LINCOLN WAY",
            "city": "JEFFERSON",
            "state": "IA",
            "postal_code": "501291645",
            "telephone_number": "515-386-2114",
            "fax_number": "515-386-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE COUNTY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "BUTTERFIELD",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "HERMAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-386-2114"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IA",
            "license": "370024H",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0744946",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.