NPIMap

Organization Active NPI

Montgomery County Memorial Hospital

  • Internal Medicine Physician
  • Red Oak, IA
National Provider Identifier
1265405310
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MONTGOMERY COUNTY MEMORIAL HOSPITAL
Practice address
2301 Eastern Ave
Red Oak, IA 51566-1305
Phone
(712) 623-7000
Fax
(712) 623-7224
NPI assigned
Feb 9, 2006
Last updated
Apr 15, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MONTGOMERY COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Authorized official

Name
Michael C Oneal
Title
Administrator/Ceo
Phone
(712) 623-7142

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X NU
Emergency Medicine Physician 207P00000X NU
Internal Medicine Physician 207R00000X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU
Surgery Physician 208600000X NU
Physician Assistant 363A00000X NU
Family Nurse Practitioner 363LF0000X NU
Certified Registered Nurse Anesthetist 367500000X NU

Addresses

Primary practice location

2301 Eastern Ave
Red Oak, IA 51566-1305

Mailing address

PO Box 498
Red Oak, IA 51566-0498
Phone (712) 623-7000

Other identifiers 1

IdentifierTypeStateIssuer
0092577MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031211000423 IA Part B Supplier - Clinic/Group Practice 9032015805 Receives reassigned benefits from 78 practitioners
1 other NPI on this enrollment
Practice locations: Malvern, IA; Villisca, IA; Stanton, IA; Shenandoah, IA; Red Oak, IA; Clarinda, IA; Atlantic, IA
O20210108002274 NE Part B Supplier - Clinic/Group Practice 9032015805 Receives reassigned benefits from 14 practitioners
Practice locations: Lincoln, NE; Roca, NE; Omaha, NE; Elkhorn, NE

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Montgomery County Memorial Hospital

Locations

1400 Senate Ave
Red Oak, IA 51566
Phone (712) 623-7250

1400 Senate Ave
Ste 400
Red Oak, IA 51566

2301 Eastern Ave
#498
Red Oak, IA 51566

37799 Professional Center Dr
Livonia, MI 48154
Phone (734) 464-3251

Practitioners & affiliated clinicians

Practitioners 92

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 92

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1265405310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 498",
            "city": "RED OAK",
            "state": "IA",
            "postal_code": "515660498",
            "telephone_number": "712-623-7000",
            "fax_number": "712-623-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 EASTERN AVE",
            "city": "RED OAK",
            "state": "IA",
            "postal_code": "515661305",
            "telephone_number": "712-623-7000",
            "fax_number": "712-623-7224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONTGOMERY COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2006-02-09",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "ONEAL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "712-623-7142"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0092577",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Oak, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.