NPIMap

Organization Active NPI

Ida County Iowa Community Hospital

  • Cardiovascular Disease Physician
  • Ida Grove, IA
National Provider Identifier
1497862981
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
IDA COUNTY IOWA COMMUNITY HOSPITAL
Practice address
701 E 2ND St
Ida Grove, IA 51445-1699
Phone
(712) 364-3311
NPI assigned
Aug 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Authorized official

Name
Joni G. Schumann
Title
Cfo
Phone
(712) 364-3311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

701 E 2ND St
Ida Grove, IA 51445-1699

Mailing address

701 E 2ND St
Ida Grove, IA 51445-1699
Phone (712) 364-3311

Other identifiers 2

IdentifierTypeStateIssuer
31633OtherIABLUE CROSS
8146969MedicaidIA

Other names 1

  • Horn Memorial Hospital Cardiographers Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323001795 IA Part B Supplier - Clinic/Group Practice 9537070826 Receives reassigned benefits from 43 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ida Grove, IA; Sioux City, 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
Tax ID family
Memorial Hosp Pulmonhor9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

701 2nd St
Ida Grove, IA 51445

801 5th St
Ste 410
Sioux City, IA 51101
Phone (712) 239-4702

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1497862981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E 2ND ST",
            "city": "IDA GROVE",
            "state": "IA",
            "postal_code": "514451699",
            "telephone_number": "712-364-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E 2ND ST",
            "city": "IDA GROVE",
            "state": "IA",
            "postal_code": "514451699",
            "telephone_number": "712-364-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDA COUNTY IOWA COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "SCHUMANN",
        "authorized_official_first_name": "JONI",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "712-364-3311"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "31633",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8146969",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horn Memorial Hospital Cardiographers",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Horn Memorial Hospital Cardiographers",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ida Grove, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.