NPIMap

Organization Active NPI

Pella Regional Health Center

Doing business as Prairie City Medical Clinic

  • Non-Pharmacy Dispensing Site
  • Prairie City, IA
National Provider Identifier
1245712942
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
PELLA REGIONAL HEALTH CENTER
Doing business as
Prairie City Medical Clinic
Practice address
404 East 2ND Street
Prairie City, IA 50228-0430
Phone
(515) 994-2617
Fax
(515) 994-2365
NPI assigned
Aug 30, 2018
Last updated
Nov 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Authorized official

Name
Robert D. Kroese
Title
Ceo
Phone
(641) 628-6604

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NU Primary

Addresses

Primary practice location

404 East 2ND Street
Prairie City, IA 50228-0430

Mailing address

404 East 2ND Street
Prairie City, IA 50228-0430
Phone (515) 994-2617

Other names 1

  • Prairie City Medical Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address prhc@direct.pellahealth.kobledirect.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Pella Medical Clinic13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

404 E 2nd St
Prairie City, IA 50228
Phone (515) 994-2617

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1245712942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 EAST 2ND STREET",
            "city": "PRAIRIE CITY",
            "state": "IA",
            "postal_code": "502280430",
            "telephone_number": "515-994-2617",
            "fax_number": "515-994-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 EAST 2ND STREET",
            "city": "PRAIRIE CITY",
            "state": "IA",
            "postal_code": "502280430",
            "telephone_number": "515-994-2617",
            "fax_number": "515-994-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELLA REGIONAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-30",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "KROESE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-628-6604"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "prhc@direct.pellahealth.kobledirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "404 East 2nd Street",
            "city": "Prairie City",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502280430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Prairie City Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prairie City Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prairie City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.