NPIMap

Organization Active NPI

Madison County Memorial Hospital

  • Emergency Care Clinic/Center
  • Winterset, IA
National Provider Identifier
1386709129
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
MADISON COUNTY MEMORIAL HOSPITAL
Practice address
300 W Hutchings St
Winterset, IA 50273-2104
Phone
(515) 462-2373
Fax
(515) 462-9060
NPI assigned
Dec 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Authorized official

Name
Mrs. Marcia L Hendricks
Title
Ceo
Phone
(515) 462-2373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X Primary

Addresses

Primary practice location

300 W Hutchings St
Winterset, IA 50273-2104

Mailing address

300 W Hutchings St
Winterset, IA 50273-2104
Phone (515) 462-2373

Other identifiers 2

IdentifierTypeStateIssuer
0187708MedicaidIA
18770OtherIABCBS

Other names 1

  • Madison County ER Doc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031126000714 IA Part B Supplier - Clinic/Group Practice 6002727179 Receives reassigned benefits from 46 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winterset, IA; West Des Moines, IA; Clive, IA; Des Moines, IA

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1386709129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HUTCHINGS ST",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "502732104",
            "telephone_number": "515-462-2373",
            "fax_number": "515-462-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HUTCHINGS ST",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "502732104",
            "telephone_number": "515-462-2373",
            "fax_number": "515-462-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-462-2373",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0187708",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "18770",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison County ER Doc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winterset, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.