Clarinda Regional Health Center

Organization Active NPI Critical Access Hospital · Clarinda, IA

NPI 1366486946 · NPPES record last updated May 21, 2014

Key facts

NPI
1366486946
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 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
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 4

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

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

Facilities with the same owner 2

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

Practitioners 81

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 81

Affiliated clinicians 132

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

View all 132

Medicare Care Compare: Hospital

Listed as
Clarinda Regional Health Center CCN 161352
Overall star rating
★★★★☆ 4 of 5
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IA

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
Government · Non-profit
Enrollment address
220 Essie Davison Dr
Clarinda, IA 51632-2915
Main/Primary Hospital Location

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 Director
Board Member
Jan 22, 2018
Dale D Fulk
Individual
Corporate Director
Board 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 Director
Board Member
Jan 1, 2018
Tyler Hill
Individual
Corporate Officer
Cno
Dec 5, 2018 100%
W-2 Managing Employee
Cno
Dec 5, 2018 100%
Katharine Boysen
Individual
Corporate Director
Board Member
Jan 1, 2018
Charles W. Nordyke
Individual
Corporate Officer
Ceo/Administrator
Jun 29, 2018 100%
W-2 Managing Employee
Ceo/Administrator
Feb 1, 2021 100%
Jeffrey Clark
Individual
Corporate Director
Board Member
Dec 17, 2019

Medicare enrollment records

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

National Provider Directory

Locations

220 Essie Davison Dr
Clarinda, IA 51632
Phone (712) 542-8330

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Yes

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

Other providers in Clarinda, IA

All providers in Clarinda, IA · Critical Access Hospital in Iowa

Sources for this page

Verify at the official NPI Registry.