NPIMap

Organization Active NPI

Van Buren County Hospital

  • Emergency Medicine Physician
  • Keosauqua, IA
National Provider Identifier
1316063076
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
VAN BUREN COUNTY HOSPITAL
Practice address
304 Franklin St
Keosauqua, IA 52565-1164
Phone
(319) 293-3171
Fax
(319) 293-6241
NPI assigned
Mar 22, 2007
Last updated
Nov 13, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
VAN BUREN COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Authorized official

Name
Ms. Kara M. McEntee
Title
Cfo
Phone
(319) 293-3171

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

304 Franklin St
Keosauqua, IA 52565-1164

Mailing address

304 Franklin St
Keosauqua, IA 52565-1164
Phone (319) 293-3171

Other identifiers 1

IdentifierTypeStateIssuer
0131680MedicaidIA

Other names 1

  • Van Buren County Hospital ER Physicians Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040329001814 IA Part B Supplier - Clinic/Group Practice 7214829530 Receives reassigned benefits from 60 practitioners
Practice locations: Keosauqua, IA

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Part of
VBCH - Dermatology

Practitioners & affiliated clinicians

Practitioners 60

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 60

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384300800000",
    "number": "1316063076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 FRANKLIN ST",
            "city": "KEOSAUQUA",
            "state": "IA",
            "postal_code": "525651164",
            "telephone_number": "319-293-3171",
            "fax_number": "319-293-6241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 FRANKLIN ST",
            "city": "KEOSAUQUA",
            "state": "IA",
            "postal_code": "525651164",
            "telephone_number": "319-293-3171",
            "fax_number": "319-293-6241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN BUREN COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VAN BUREN COUNTY HOSPITAL",
        "enumeration_date": "2007-03-22",
        "last_updated": "2013-11-13",
        "status": "A",
        "authorized_official_last_name": "MCENTEE",
        "authorized_official_first_name": "KARA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "319-293-3171",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0131680",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Van Buren County Hospital ER Physicians",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Keosauqua, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.