NPIMap

Organization Active NPI

St Luke's Methodist Hospital

  • Psychiatric Hospital Unit
  • Cedar Rapids, IA
National Provider Identifier
1356433015
Registry record updated Jul 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
57S045 Issued in 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
Last updated
Jul 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2009

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

Authorized official

Name
Mr. Milton E Aunan
Title
Cfo
Phone
(319) 369-7094

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 57S045 IA Primary

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071128000199 IA Part A Provider - Hospital 6608786751 Practice locations: Cedar Rapids, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356433015. Details of each certification follow.

Hospital certification: CCN 16S045

Legal name
ST LUKES METHODIST HOSPITAL
Doing business as
ST LUKES HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Jan 24, 1897 in IA
Enrollment address
1026 A Ave NE
Cedar Rapids, IA 52402-5036
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Amy B Kapler PA17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kathleen Minette Individual Corporate Director Jan 19, 2012
Charles Becker Individual Corporate Director Jan 1, 2016
Casey S Greene Individual Corporate OfficerMarket President Aug 27, 2023
W-2 Managing EmployeeMarket President Mar 27, 2023
Clay Holderman Individual Operational/Managerial ControlHome Chain Officer President/Ceo Feb 8, 2021
Gregory Churchill Individual Corporate Director Jan 1, 2014
Sally W Gray Individual Corporate Director Dec 14, 2007
Steven M Wahle Individual Corporate Director Jan 21, 2010
Anne H Carter Individual Corporate DirectorDirector Jan 1, 2021
Robin Kay Mixdorf Individual Corporate Director Dec 14, 2007
Steven L Caves Individual Corporate Director Jan 1, 2023
Kathryn Epley Individual Corporate Director Jan 1, 2022
Anne Parmley Individual Corporate DirectorDirector Jan 1, 2020
Iowa Health System Organization, West Des Moines, IA Non-profit Other Jan 1, 1995
William P Prowell Individual Corporate Director Dec 14, 2007
Brian R Globakar Individual Corporate DirectorDirector Jan 1, 2021
Heather Robertson Individual Corporate Director Jan 1, 2023
Lori Sundberg Individual Corporate DirectorDirector Jan 1, 2019

Practitioners & affiliated clinicians

Practitioners 9

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": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247702400000",
    "number": "1356433015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7165",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503097165",
            "telephone_number": "319-369-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 A AVE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025036",
            "telephone_number": "319-369-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKE'S METHODIST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2009-07-16",
        "status": "A",
        "authorized_official_last_name": "AUNAN",
        "authorized_official_first_name": "MILTON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "319-369-7094",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "IA",
            "license": "57S045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.