Greater Regional Medical Center
Organization Active NPI Rural Health Clinic/Center · Lenox, IA
NPI 1346353323 · NPPES record last updated Apr 24, 2013
Key facts
- NPI
- 1346353323
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- GREATER REGIONAL MEDICAL CENTER
- Practice address
- 100 S Main St
Lenox, IA 50851-1240 - Phone
- (641) 333-4545
- Fax
- (641) 333-4547
- NPI assigned
- Aug 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Matthew L McCutchan
- Title
- Cfo
- Phone
- (641) 782-3899
Owners & managing parties with NPI records 8
-
James D Gerdes, DO
-
Kenneth D Stults, OD
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 7
Related certifications (CCN) 1
Facilities with the same owner 22
Practitioners 48
-
Eric Wayne Anderson, CRNA
-
Gregory A Anderson, CRNA
-
Leeann K Berg, ARNP
-
Shelby Cameron, ARNP, FNP-BC
-
Benjamin Carmack, PA-C
-
Sarah Carter, ARNP
-
Melissa Ann Cowan, ARNP
-
Brian A Dumstorff, CRNA
-
Kathleen Nicole Evans, CRNA
-
Jonathan M Fialkov, M.D.
-
David Gantz, DO
-
Adam Daniel Gliniewicz, M.D.
-
Emily Hawbaker, ARNP
-
Amy Slee Hynek McFarland, D.O.
-
Stephanie Maxine Krauth, CRNA ARNP
-
Karen J Krogstad, MD
-
Kendall Lange, ARNP
-
Eric M Larsen, DPM
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D0932722 | Lenox Medical Clinic | Certificate of waiver | Jan 22, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Rural health clinic certification: CCN 163469
- Legal name
- GREATER REGIONAL MEDICAL CENTER
- Doing business as
- LENOX MEDICAL CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Nov 10, 1997
- Last certification
- Apr 8, 2020
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Enrollment address
- 100 S Main St
Lenox, IA 50851-1240 - Related CCNs
- 161365
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Sharon Kay McKie |
Corporate Officer | Jan 1, 2011 | |
| Corporate Director | Jan 1, 1997 | ||
| Lucas E Neitzel |
W-2 Managing Employee |
Mar 6, 2017 | |
| Operational/Managerial Control |
Mar 6, 2017 | ||
| Central Iowa Hospital Corporation |
Operational/Managerial Control | Jul 1, 2017 | |
| Kenneth Dawson Stults |
Corporate Officer | Jan 27, 2025 | |
| Corporate Director | Jan 26, 2015 | ||
| Thomas L Lesan |
Corporate Officer | Jan 23, 2023 | |
| Corporate Director | Mar 11, 2010 | ||
| James D Gerdes |
W-2 Managing Employee |
Jun 1, 2021 | |
| Operational/Managerial Control |
Jun 1, 2021 | ||
| Matthew L McCutchan |
Corporate Officer |
Nov 25, 2013 | |
| W-2 Managing Employee |
Mar 29, 2009 | ||
| Operational/Managerial Control |
Mar 29, 2009 | ||
| Julie a Lanning |
Corporate Director | Aug 26, 2019 | |
| R Jack Davis |
Corporate Officer | Jan 23, 2012 | |
| Corporate Director | Jan 1, 1995 | ||
| Monte E. Neitzel |
Corporate Officer |
Nov 25, 2013 | |
| W-2 Managing Employee |
Aug 4, 2003 | ||
| Operational/Managerial Control |
Aug 4, 2003 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090918000499 | IA | Part a Provider - Rural Health Clinic | 9234041013 | Practice locations: Lenox, IA |
National Provider Directory
- Tax ID family
- Greater Community Hosp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes | ||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
100 S Main St
Lenox, IA 50851-1240
Mailing address
1700 W Townline St
Creston, IA 50801-1054
Phone (641) 782-7091
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0634691 | Medicaid | IA |
Other names
- Lenox Medical Clinic
Other providers in Lenox, IA
- Alegent Health - Mercy Hospital, Corning, Iowa
- Peter L Brantner
- City of Lenox
- Chimene Lynn Cobb
- Bailey J Drake
- GRX Holdings LLC
- Lenox Care Center, Inc.
- Lenox Community School District
- Christopher Lyle Leonard
- Alicia Lynn
All providers in Lenox, IA · Rural Health Clinic/Center in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2013. 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.