NPIMap

Organization Active NPI

Burgess Health Center

  • Emergency Medicine Physician
  • Onawa, IA
National Provider Identifier
1538234232
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
BURGESS HEALTH CENTER
Practice address
1600 Diamond St
Onawa, IA 51040-1548
Phone
(712) 423-2311
Fax
(712) 423-9199
NPI assigned
Nov 21, 2006
Last updated
Jul 24, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BURGESS HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Authorized official

Name
Lynn R Wold
Title
Ceo
Phone
(712) 423-2311

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Family Nurse Practitioner 363LF0000X
Certified Registered Nurse Anesthetist 367500000X
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

1600 Diamond St
Onawa, IA 51040-1548

Mailing address

1600 Diamond St
Onawa, IA 51040-1548
Phone (712) 423-2311

Other identifiers 1

IdentifierTypeStateIssuer
0272237MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031219000549 IA Part B Supplier - Clinic/Group Practice 0143131516 Receives reassigned benefits from 27 practitioners
7 other NPIs on this enrollment
Practice locations: Onawa, IA

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Part of
Burgess Memorial Hosp E

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721779200000",
    "number": "1538234232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 DIAMOND ST",
            "city": "ONAWA",
            "state": "IA",
            "postal_code": "510401548",
            "telephone_number": "712-423-2311",
            "fax_number": "712-423-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DIAMOND ST",
            "city": "ONAWA",
            "state": "IA",
            "postal_code": "510401548",
            "telephone_number": "712-423-2311",
            "fax_number": "712-423-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURGESS HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BURGESS HEALTH CENTER",
        "enumeration_date": "2006-11-21",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "WOLD",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "712-423-2311"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0272237",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Onawa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.