NPIMap

Organization Active NPI

Jackson County Public Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Maquoketa, IA
National Provider Identifier
1316901606
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
490099H Issued in IA
Legal business name
JACKSON COUNTY PUBLIC HOSPITAL
Practice address
700 W Grove St
Maquoketa, IA 52060-2163
Phone
(563) 652-2474
Fax
(563) 652-4096
NPI assigned
Apr 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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

Authorized official

Name
Curt M Coleman
Title
Ceo
Phone
(563) 652-4020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 490099H IA Primary

Addresses

Primary practice location

700 W Grove St
Maquoketa, IA 52060-2163

Mailing address

700 W Grove St
Maquoketa, IA 52060-2163
Phone (563) 652-2474

Other identifiers 1

IdentifierTypeStateIssuer
0600569MedicaidIA

Other names 1

  • JACKSON COUNTY REGIONAL HEALTH CENTER Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1316901606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W GROVE ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602163",
            "telephone_number": "563-652-2474",
            "fax_number": "563-652-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W GROVE ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602163",
            "telephone_number": "563-652-2474",
            "fax_number": "563-652-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY PUBLIC HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "CURT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-652-4020"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "IA",
            "license": "490099H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0600569",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACKSON COUNTY REGIONAL HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maquoketa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.