NPIMap

Organization Active NPI

Delaware County Memorial Hospital

Doing business as Regional Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Manchester, IA
National Provider Identifier
1326073669
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
DELAWARE COUNTY MEMORIAL HOSPITAL
Doing business as
Regional Medical Center
Practice address
709 W Main St
Manchester, IA 52057-1526
Phone
(563) 927-3232
Fax
(563) 927-7577
NPI assigned
Jul 12, 2006
Last updated
Jun 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Lon Butikofer, RN, PHD
Title
Ceo
Phone
(563) 927-3232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X NU Primary

Addresses

Primary practice location

709 W Main St
Manchester, IA 52057-1526

Mailing address

709 W Main St
Manchester, IA 52057-1526
Phone (563) 927-3232

Other identifiers 2

IdentifierTypeStateIssuer
0133983MedicaidIA
13398OtherIABCIA

Other names 1

  • REGIONAL MEDICAL CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000881 IA Part B Supplier - Clinic/Group Practice 2062316375 Receives reassigned benefits from 178 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dyersville, IA; Winthrop, IA; Manchester, IA; Strawberry PT, IA

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 122

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 122

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1326073669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571526",
            "telephone_number": "563-927-3232",
            "fax_number": "563-927-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571526",
            "telephone_number": "563-927-3232",
            "fax_number": "563-927-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "BUTIKOFER",
        "authorized_official_first_name": "LON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-927-3232",
        "authorized_official_credential": "RN, PHD"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133983",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCIA",
            "identifier": "13398",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.