NPIMap

Organization Active NPI

Clarinda Regional Health Center

  • Critical Access Hospital
  • Clarinda, IA
National Provider Identifier
1366486946
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
CLARINDA REGIONAL HEALTH CENTER
Practice address
220 Essie Davison Dr
Clarinda, IA 51632-2915
Phone
(712) 542-2176
NPI assigned
Jun 15, 2006
Last updated
May 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Authorized official

Name
Elaine Otte
Title
Coo
Phone
(712) 542-2176

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

220 Essie Davison Dr
Clarinda, IA 51632-2915

Mailing address

PO Box 217
Clarinda, IA 51632-2625
Phone (712) 542-2176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031205000207 IA Part B Supplier - Clinic/Group Practice 4587573993 Receives reassigned benefits from 149 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Atlantic, IA; Villisca, IA; Sidney, IA; Red Oak, IA; Hamburg, IA; Clarinda, IA; Bedford, IA
O20061104000118 IA Part A Provider - Critical Access Hospital 4587573993 Receives reassigned benefits from 70 practitioners
Practice locations: Bedford, IA; Clarinda, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366486946. Details of each certification follow.

Hospital certification: CCN 161352

Legal name
CLARINDA REGIONAL HEALTH CENTER
Doing business as
CLARINDA REGIONAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 1, 2003
Last certification
Apr 13, 2017
Beds
25
Ownership / control type
Local
Organization structure
GovernmentNon-profit
Enrollment address
220 Essie Davison Dr
Clarinda, IA 51632-2915
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Clarinda Regional Health CenterCCN 161352 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Bryan L Whipp Individual Corporate DirectorBoard Member Jan 22, 2018
Dale D Fulk Individual Corporate DirectorBoard Member Jan 1, 2018
City of Clarinda Organization, Clardina, IA 5% Or Greater Direct Ownership Interest Nov 14, 2007 100%
Robert J Marsh Individual Corporate DirectorBoard Member Jan 1, 2018
Tyler Hill Individual Corporate OfficerCno Dec 5, 2018 100%
W-2 Managing EmployeeCno Dec 5, 2018 100%
Katharine Boysen Individual Corporate DirectorBoard Member Jan 1, 2018
Charles W. Nordyke Individual Corporate OfficerCeo/Administrator Jun 29, 2018 100%
W-2 Managing EmployeeCeo/Administrator Feb 1, 2021 100%
Jeffrey Clark Individual Corporate DirectorBoard Member Dec 17, 2019

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 77

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.

View all 77

Affiliated clinicians 132

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 132

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400630400000",
    "number": "1366486946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 217",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516322625",
            "telephone_number": "712-542-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 ESSIE DAVISON DR",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516322915",
            "telephone_number": "712-542-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARINDA REGIONAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2014-05-21",
        "status": "A",
        "authorized_official_last_name": "OTTE",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "712-542-2176"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarinda, IA

Sources for this page

Verify at the official NPI Registry.