Cass County Memorial Hospital
Organization Active NPI Family Medicine Physician · Atlantic, IA
NPI 1316148307 · NPPES record last updated Jan 16, 2023
Key facts
- NPI
- 1316148307
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CASS COUNTY MEMORIAL HOSPITAL
- Practice address
- 1501 E 10TH St
Atlantic, IA 50022-1936 - Phone
- (712) 243-2850
- Fax
- (712) 243-7423
- NPI assigned
- May 29, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- CASS COUNTY MEMORIAL HOSPITAL
Authorized official
- Name
- Abbey Stangl
- Title
- Chief Financial Officer
- Phone
- (712) 243-3250
Owners & managing parties with NPI records 9
-
Elaine K. Berry, M.D.
Owned or controlled facilities with NPI records 2
Other NPIs on the same Medicare enrollment 4
Other NPIs with the same Medicare PAC ID 8
Related certifications (CCN) 1
Facilities with the same owner 2
Practitioners 69
-
Elisha Hardy, ARNP
-
Chad L McCance, MD
-
George M Starlin, PA
-
Kristin Kay Babb, PA
-
Seann M Atkinson, DO
-
William K Barnhill, CRNA
-
Stacey L Bean, PA-C
-
Elaine K. Berry, M.D.
-
Amy Bingaman, MD
-
Kevin F Bohac, CRNA
-
Emily Chang, D.O.
-
Holly Christensen, ARNP
-
Melissa Jo Frazier, DNP ARNP
-
Megan Marie Frederiksen, ARNP
-
Jeffrey Michael Goergen, O.D.
-
Becki M. Goldberg-Kahn, M.D.
-
Brent F Goodrich, CRNA
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D1000619 | Griswold Medical Center | Certificate of waiver | Jun 18, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA
Rural health clinic certification: CCN 168525
- Legal name
- CASS COUNTY MEMORIAL HOSPITAL
- Doing business as
- GRISWOLD MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Oct 1, 2007
- Last certification
- Aug 3, 2021
- Ownership / control type
- 2B
- Organization structure
- Other · Non-profit
- Enrollment address
- 1109 Morningside Dr
Griswold, IA 51535-8067 - Related CCNs
- 161376
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Brett a Altman |
Corporate Officer |
Jan 3, 2017 | |
| W-2 Managing Employee |
Jan 3, 2017 | ||
| Operational/Managerial Control |
Jan 3, 2017 | ||
| Nathan Brown |
Corporate Director | Mar 24, 2009 | |
| Linda Pelzer |
Corporate Director | Nov 20, 2019 | |
| Julia Ann Pollock |
Corporate Director | Jan 1, 2013 | |
| Cass County Memorial Hospital |
Operational/Managerial Control | May 25, 2007 | |
| Kolton E Hewlett |
Corporate Officer |
Dec 30, 2023 | |
| W-2 Managing Employee |
Dec 30, 2023 | ||
| Elaine K Berry |
W-2 Managing Employee |
Aug 1, 2021 | |
| Joanne Lorence |
Corporate Director | Jul 20, 2016 | |
| Leanne Pellett |
Corporate Director | Jan 1, 2009 | |
| Roger Lynn Herring |
Corporate Director | Jan 1, 2013 | |
| Michael John Klocke |
Corporate Director | Jan 1, 2017 |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Massena Medical Center |
Rural health clinic | Operational/Managerial Control | May 25, 2007 |
| Anita Medical Center |
Rural health clinic | Operational/Managerial Control | May 25, 2007 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031231000681 | IA | Part B Supplier - Clinic/Group Practice | 5294634994 |
Receives reassigned benefits from 126 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Anita, IA; Atlantic, IA; Clarinda, IA; Griswold, IA; Massena, IA; Red Oak, IA |
| O20070605000089 | IA | Part a Provider - Rural Health Clinic | 5294634994 | Practice locations: Griswold, IA |
National Provider Directory
- Part of
- Coss County Memorial Ho
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Rural Health Clinic/Center | 261QR1300X |
Addresses
Primary practice location
1501 E 10TH St
Atlantic, IA 50022-1936
Mailing address
1109 Morningside Drive
Griswold, IA 51535-0099
Phone (712) 778-5140
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316148307 | Medicaid | IA |
Other names
- Griswold Medical Center RHC
Other providers in Atlantic, IA
- Cass County Memorial Hospital
- Cass County Memorial Hospital
- Cass County Memorial Hospital
- Cass County Memorial Hospital
- Cass County Memorial Hospital
- Cass County Memorial Hospital
- Cass County Memorial Hospital
- Cass County Memorial Hospital
- Cass County Memorial Hospital
- Cass County Memorial Hospital Foundation
All providers in Atlantic, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.