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Jefferson County Hospital

Organization Active NPI Rural Health Clinic/Center · Fairfield, IA

NPI 1457728008 · NPPES record last updated May 21, 2025

Key facts

NPI
1457728008
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
License
510063H (IA)
Legal business name
JEFFERSON COUNTY HOSPITAL
Practice address
2000B S Main St
Fairfield, IA 52556-9572
Phone
(641) 472-4156
Fax
(641) 469-4375
NPI assigned
Aug 31, 2015
Organization subpart
No

Authorized official

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

Owned or controlled facilities with NPI records 2

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

Other NPIs with the same Medicare PAC ID 3

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

Corporate family (same tax ID) 10

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

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

Practitioners 64

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

View all 64

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IA

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
Other · Non-profit
Enrollment address
2000B S Main St
Fairfield, IA 52556-9572
Related CCNs
161364

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 Control
Cfo		 Jan 1, 2023 100%
Merlin D Miller
Individual 		Corporate Director
Chair		 Jan 1, 2007
Renee Rebling
Individual 		Corporate Director
Board Member		 Jan 1, 2009
Greg Hanshaw
Individual 		Corporate Director
Vice- Chair		 Jan 1, 2011
Trent Hammes
Individual 		Corporate Director
Board Member		 Jan 1, 2018
Joneane Parker
Individual 		Corporate Director
Secretary of Treasury		 Jan 1, 2016
Julie Greeson
Individual 		Corporate Director
Board 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 Center
Fairfield, IA · CCN 161364		 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2004
Jefferson County Health Center
Fairfield, IA · CCN 16Z364		 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2004

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20151009000061 IA Part a Provider - Rural Health Clinic 9335059575 Practice locations: Fairfield, IA

National Provider Directory

Tax ID family
Jefferson Co Hospitla (11 organizations share this tax ID)

Locations

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

Specialties & licenses

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

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

  • JCHC Rural Health Clinic Doing business as
  • Jefferson County Health Center Doing business as

Other providers in Fairfield, IA

All providers in Fairfield, IA · Rural Health Clinic/Center in Iowa

Sources for this page

Verify at the official NPI Registry.