NPIMap

Organization Active NPI

Jefferson County Hospital

Doing business as JCHC Rural Health Clinic

  • Rural Health Clinic/Center
  • Fairfield, IA
National Provider Identifier
1457728008
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
510063H Issued in IA
Legal business name
JEFFERSON COUNTY HOSPITAL
Doing business as
JCHC Rural Health Clinic
Jefferson County Health Center
Practice address
2000B S Main St
Fairfield, IA 52556-9572
Phone
(641) 472-4156
Fax
(641) 469-4375
NPI assigned
Aug 31, 2015
Last updated
May 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 510063H IA Primary

Addresses

Primary practice location

2000B S Main St
Fairfield, IA 52556-9572

Mailing address

2000 S Main St
Fairfield, IA 52556-9572
Phone (641) 472-4156

Other names 2

  • JCHC Rural Health Clinic Doing business as
  • 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
O20151009000061 IA Part A Provider - Rural Health Clinic 9335059575 Practice locations: Fairfield, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457728008. Details of each certification follow.

Rural health clinic certification: CCN 168572

Legal name
JEFFERSON COUNTY HOSPITAL
Doing business as
JCHC RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 28, 2015
Last certification
Nov 14, 2018
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
2000B S Main St
Fairfield, IA 52556-9572
Related CCNs
161364

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).

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.

Locations

2000 S Main St
Fairfield, IA 52556
Phone (641) 469-4204

Ownership & related parties

All disclosed owners & managing parties 7

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 Operational/Managerial ControlCfo Jan 1, 2023 100%
Merlin D Miller Individual Corporate DirectorChair Jan 1, 2007
Renee Rebling Individual Corporate DirectorBoard Member Jan 1, 2009
Greg Hanshaw Individual Corporate DirectorVice- Chair Jan 1, 2011
Trent Hammes Individual Corporate DirectorBoard Member Jan 1, 2018
Joneane Parker Individual Corporate DirectorSecretary of Treasury Jan 1, 2016
Julie Greeson Individual Corporate DirectorBoard Member Jan 1, 2011

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Jefferson County Health CenterFairfield, IA, CCN 161364 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2004
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 2

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

Practitioners & affiliated clinicians

Practitioners 43

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 43

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1457728008",
    "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": "641-472-4156",
            "fax_number": "641-469-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000B S MAIN ST",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525569572",
            "telephone_number": "641-472-4156",
            "fax_number": "641-469-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-31",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "FEICKERT",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "641-469-4304"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IA",
            "license": "510063H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JCHC Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JCHC Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "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.