NPIMap

Organization Active NPI

Decatur County Hospital

Doing business as Decatur County Hospital Professional Fees

  • Medical Oncology Physician
  • Leon, IA
National Provider Identifier
1336356906
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
Legal business name
DECATUR COUNTY HOSPITAL
Doing business as
Decatur County Hospital Professional Fees
Decatur County Hospital- ER Group
Practice address
1405 NW Church St
Leon, IA 50144-1205
Phone
(641) 446-4871
NPI assigned
May 16, 2007
Last updated
Jan 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
Michael Johnston
Title
Ceo
Phone
(641) 446-4871

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 270089H IA
Nurse Practitioner 363L00000X 270089H IA
Certified Registered Nurse Anesthetist 367500000X 270089H IA
Emergency Medicine Physician 207P00000X 270089H IA
Medical Oncology Physician 207RX0202X NU Primary
Surgery Physician 208600000X 270089H IA

Addresses

Primary practice location

1405 NW Church St
Leon, IA 50144-1205

Mailing address

1405 NW Church St
Leon, IA 50144-1266
Phone (641) 446-4871

Other identifiers 2

IdentifierTypeStateIssuer
51884OtherIABC GROUP#
6169912MedicaidIA

Other names 2

  • Decatur County Hospital Professional Fees Doing business as
  • Decatur County Hospital- ER Group Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dch@dch.cernerdirect.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031210000758 IA Part B Supplier - Clinic/Group Practice 9739085754 Receives reassigned benefits from 72 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Leon, IA

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

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1336356906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 NW CHURCH ST",
            "city": "LEON",
            "state": "IA",
            "postal_code": "501441266",
            "telephone_number": "641-446-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 NW CHURCH ST",
            "city": "LEON",
            "state": "IA",
            "postal_code": "501441205",
            "telephone_number": "641-446-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-446-4871"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "270089H",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "270089H",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "270089H",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "270089H",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "270089H",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC GROUP#",
            "identifier": "51884",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6169912",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dch@dch.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "DCH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1405 NW Church St",
            "city": "Leon",
            "state": "IA",
            "country_code": "US",
            "postal_code": "501441266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Decatur County Hospital Professional Fees",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Decatur County Hospital- ER Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Decatur County Hospital- ER Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leon, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.