St Luke'S Methodist Hospital
Organization Active NPI Psychiatric Hospital Unit · Cedar Rapids, IA
NPI 1356433015 · NPPES record last updated Jul 16, 2009
Key facts
- NPI
- 1356433015
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- License
- 57S045 (IA)
- Legal business name
- ST LUKE'S METHODIST HOSPITAL
- Practice address
- 1026 A Ave NE
Cedar Rapids, IA 52402-5036 - Phone
- (319) 369-7211
- NPI assigned
- Sep 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Milton E Aunan
- Title
- Cfo
- Phone
- (319) 369-7094
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 16
Member of 1
Member organizations 10
Related certifications (CCN) 1
Practitioners 86
-
Brittney Nicole Both, ARNP
-
Amanda Mary Forystek, M.D.
-
Jacob N Miller, M.D.
-
Evan Ouyang, MD
-
Fahed Al Darazi, MD
-
Nicholas R Appleby, D.O.
-
Dustin Leclere Arnold, D.O.
-
Erin Balk, ARNP
-
Carrie Ann Campbell, AGACNP-BC
-
Alexia Joi Davelaar, PHD
-
Tiffany Marie Ehlers, ARNP
-
Talha A. Farid, MD
-
Bernard Michael Feldman, D.O.
-
Katie Elizabeth Fischels, AGACNP
-
Emily Fye, NP-C
-
Molly Garber, ARNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Hospital certification: CCN 16S045
- Legal name
- ST LUKES METHODIST HOSPITAL
- Doing business as
- ST LUKES HOSPITAL
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 24, 1897 in IA
- Enrollment address
- 1026 A Ave NE
Cedar Rapids, IA 52402-5036 - Hospital subgroups
- Psychiatric unit
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Kathleen Minette |
Corporate Director | Jan 19, 2012 | |
| Charles Becker |
Corporate Director | Jan 1, 2016 | |
| Casey S Greene |
Corporate Officer |
Aug 27, 2023 | |
| W-2 Managing Employee |
Mar 27, 2023 | ||
| Clay Holderman |
Operational/Managerial Control |
Feb 8, 2021 | |
| Gregory Churchill |
Corporate Director | Jan 1, 2014 | |
| Sally W Gray |
Corporate Director | Dec 14, 2007 | |
| Steven M Wahle |
Corporate Director | Jan 21, 2010 | |
| Anne H Carter |
Corporate Director |
Jan 1, 2021 | |
| Robin Kay Mixdorf |
Corporate Director | Dec 14, 2007 | |
| Steven L Caves |
Corporate Director | Jan 1, 2023 | |
| Kathryn Epley |
Corporate Director | Jan 1, 2022 | |
| Anne Parmley |
Corporate Director |
Jan 1, 2020 | |
| Iowa Health System |
Other | Jan 1, 1995 | |
| William P Prowell |
Corporate Director | Dec 14, 2007 | |
| Brian R Globakar |
Corporate Director |
Jan 1, 2021 | |
| Heather Robertson |
Corporate Director | Jan 1, 2023 | |
| Lori Sundberg |
Corporate Director |
Jan 1, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071128000199 | IA | Part a Provider - Hospital | 6608786751 | Practice locations: Cedar Rapids, IA |
National Provider Directory
- Tax ID family
- Ekg Physician Serv
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | 57S045 | IA | Yes |
Addresses
Primary practice location
1026 A Ave NE
Cedar Rapids, IA 52402-5036
Mailing address
PO Box 7165
Des Moines, IA 50309-7165
Phone (319) 369-7211
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6S045 | Other | IA | BLUE CROSS |
Other providers in Cedar Rapids, IA
- Sara D Spiva
- Nicole Sporrer
- Spring Valley Ventures, P.C.
- St Luke'S Methodist Hospital
- St Luke'S Methodist Hospital
- St Luke'S Methodist Hospital
- St Luke'S Methodist Hospital
- St Luke'S Methodist Hospital
- St Luke'S Methodist Hospital
- St Luke'S Methodist Hospital
All providers in Cedar Rapids, IA · Psychiatric Hospital Unit in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2009. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.