NPIMap

Organization Active NPI

Jefferson County Hospital

Doing business as Jefferson County Health Center

  • Critical Access Hospital
  • Fairfield, IA
National Provider Identifier
1376648329
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
510063H Issued in IA
Legal business name
JEFFERSON COUNTY HOSPITAL
Doing business as
Jefferson County Health Center
Practice address
2000 S Main St
Fairfield, IA 52556-9572
Phone
(641) 472-4111
Fax
(641) 469-4375
NPI assigned
Sep 14, 2006
Last updated
May 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Authorized official

Name
Brent Robert Feickert
Title
Chief Financial Officer
Phone
(641) 469-4304

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 510063H IA Primary

Addresses

Primary practice location

2000 S Main St
Fairfield, IA 52556-9572

Mailing address

2000 S Main St
Fairfield, IA 52556-9572
Phone (641) 472-4111

Other identifiers 2

IdentifierTypeStateIssuer
60115OtherIAWELLMARK BC/BS OF IOWA
0601153MedicaidIA

Other names 1

  • Jefferson County Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000156 IA Part A Provider - Critical Access Hospital 9335059575 Receives reassigned benefits from 75 practitioners
Practice locations: Fairfield, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376648329. Details of each certification follow.

Hospital certification: CCN 161364

Legal name
JEFFERSON COUNTY HOSPITAL
Doing business as
JEFFERSON COUNTY HEALTH CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Nov 1, 2004
Last certification
Jul 28, 2022
Beds
25
Ownership / control type
Local
Organization structure
OtherProprietary
Enrollment address
2000 S Main St
Fairfield, IA 52556-9572

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).

Care Compare: Hospital

Medicare Care Compare
Listed as
Jefferson County Health CenterCCN 161364 · All quality measures
Overall star rating
2 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
Tax ID family
Jefferson County Hospit11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Brent Feickert Individual Corporate OfficerCfo Jan 1, 2023
W-2 Managing EmployeeCfo Jan 1, 2023
Merlin D Miller Individual Corporate DirectorBoard Member Jan 1, 2007
Renee Rebling Individual Corporate DirectorBoard Member Nov 1, 2009
Robert Keller Individual Corporate DirectorBoard Member Jan 1, 1992
Greg Hanshaw Individual Corporate DirectorBoard Member Nov 1, 2011
Trent Hammes Individual Corporate DirectorBoard Member Jan 8, 2018
Joneane Parker Individual Corporate DirectorBoard Member Jan 1, 2018
Julie Greeson Individual Corporate DirectorBoard Member Jan 1, 2011
Jefferson County Hospital Organization, Fairfield, IA Non-profit 5% Or Greater Direct Ownership Interest Nov 1, 2004 100%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Jefferson County Health CenterFairfield, IA, CCN 16Z364 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2004

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 76

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 76

Affiliated clinicians 175

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

View all 175

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1376648329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S MAIN ST",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525569572",
            "telephone_number": "641-472-4111",
            "fax_number": "641-469-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S MAIN ST",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525569572",
            "telephone_number": "641-472-4111",
            "fax_number": "641-469-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "FEICKERT",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "641-469-4304"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IA",
            "license": "510063H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC/BS OF IOWA",
            "identifier": "60115",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0601153",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson County Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfield, IA

Sources for this page

Verify at the official NPI Registry.