Delaware County Memorial Hospital
Organization Active NPI Public Health or Welfare Agency · Manchester, IA
NPI 1356726475 · NPPES record last updated Jul 30, 2015
Key facts
- NPI
- 1356726475
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- DELAWARE COUNTY MEMORIAL HOSPITAL
- Practice address
- 613 W Main St
Manchester, IA 52057-1527 - Phone
- (563) 927-7353
- Fax
- (563) 927-7520
- NPI assigned
- Jul 30, 2015
- Organization subpart
- No
Authorized official
- Name
- Lon Butikofer, RN, PHD
- Title
- Ceo
- Phone
- (563) 927-7308
Owned or controlled facilities with NPI records 8
Other NPIs with the same Medicare PAC ID 10
Corporate family (same tax ID) 11
Practitioners 80
-
Sarah Jean Hartman, ARNP
-
Michelle S Radloff, ARNP
-
Nicole M Salow, M.D.
-
Grace Hsuanhwa Wang, M.D.
-
Seth Nicolas Additon, DNP, CRNA
-
Omar H Akhtar, MD
-
Bridget Milene Baker, DNP, ARNP, FNP-BC, P
-
Allison Rae Berns, PA-C
-
Luke Brunkhorst, D.O.
-
Janice M Budzine, ARNP
-
Jill L Buschmann, ARNP
-
Isaac Albert Butler, CRNA
-
Jennifer Marie Chastek, CRNA
-
Scott J Chastek, CRNA / ARNP
-
Scot R Christiansen, M.D.
-
Sarah Cisco, CRNA
-
Clinton Thomas Cummings, D.O.
-
Blanka Divisova, M.D.
-
Jenny Lynn Duffie, ARNP, FNP-C
-
Derek Manson Dzaboff, ARNP FNP-BC
-
April Ehrler, ARNP
-
Blake Eyberg, MD
-
Stephanie Elaine Fangman, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
All facility ownership & control disclosures 7
| Facility | Type | Role | Since |
|---|---|---|---|
| Regional Medical Center |
Hospital | Operational/Managerial Control | Aug 28, 2013 |
| Regional Medical Center |
Hospital | Operational/Managerial Control | Aug 28, 2013 |
| Regional Family Health Edgewood |
Rural health clinic | Operational/Managerial Control | Jan 1, 1966 |
| Regional Family Health Hopkinton |
Rural health clinic | Operational/Managerial Control | Apr 1, 2009 |
| Regional Family Health Manchester |
Rural health clinic | Operational/Managerial Control (100%) | Apr 1, 2009 |
| Regional Family Health Strawberry Point |
Rural health clinic | Operational/Managerial Control | Apr 1, 2009 |
| Regional Family Health Winthrop |
Rural health clinic | Operational/Managerial Control (100%) | Aug 1, 1966 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151203000389 | IA | Part B Supplier - Mass Immunization (Roster Biller Only) | 2062316375 | Practice locations: Manchester, IA |
National Provider Directory
- Tax ID family
- Delaware County Hosp
Locations
613 W Main St
Manchester, IA 52057
Phone (319) 927-2629
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes |
Addresses
Primary practice location
613 W Main St
Manchester, IA 52057-1527
Mailing address
709 W Main St
PO Box 359
Manchester, IA 52057-1526
Phone (563) 927-7457
Other names
- DELAWARE COUNTY PUBLIC HEALTH
Other providers in Manchester, IA
- Delaware County Community Services
- Delaware County Memorial Hospital
- Delaware County Memorial Hospital
- Delaware County Memorial Hospital
- Delaware County Memorial Hospital
- Delaware County Memorial Hospital
- Delaware County Memorial Hospital
- Delaware County Memorial Hospital
- Delaware County Memorial Hospital
- Delaware County Memorial Hospital
All providers in Manchester, IA · Public Health or Welfare Agency 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 30, 2015. 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.