NPIMap

Organization Active NPI

St Anthony Regional Hospital and Nursing Home

  • Diabetes Educator Registered Nurse
  • Carroll, IA
National Provider Identifier
1598327207
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
Legal business name
ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME
Practice address
311 S Clark St
Carroll, IA 51401-3038
Phone
(712) 792-3581
NPI assigned
Jul 2, 2019
Last updated
Jul 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Authorized official

Name
John Munson
Title
Cfo
Phone
(712) 794-5115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X Primary

Addresses

Primary practice location

311 S Clark St
Carroll, IA 51401-3038

Mailing address

311 S Clark St
Carroll, IA 51401-3038
Phone (712) 792-3581

Other identifiers 1

IdentifierTypeStateIssuer
140090HOtherIALICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190827001669 IA MDPP Supplier - in-Person MDPP Supplier 4688586829 Practice locations: Carroll, IA

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
St Anthony Regional Hospital11 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.

Ownership & related parties

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
BCG Data ServicesCarroll, IA, CCN 165796 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Jul 1, 2025
Jul 1, 2025
Jul 1, 2025
St Anthony Regional Hospital & Nursing HomeCarroll, IA, CCN 167207 Home health agency Operational/Managerial Control Nov 1, 1997
St Anthony Regional Hospital and Nursing HomeCarroll, IA, CCN 161546 Hospice Operational/Managerial Control Nov 1, 1997
St Anthony Regional Hospital and Nursing HomeCarroll, IA, CCN 163400 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 28, 1904

Owned or controlled facilities with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562025600000",
    "number": "1598327207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S CLARK ST",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013038",
            "telephone_number": "712-792-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S CLARK ST",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013038",
            "telephone_number": "712-792-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A",
        "authorized_official_last_name": "MUNSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "712-794-5115"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "140090H",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carroll, IA

Sources for this page

Verify at the official NPI Registry.