NPIMap

Organization Active NPI

Woodbury County Government

Doing business as Siouxland District Health Department

  • Public Health or Welfare Agency
  • Sioux City, IA
National Provider Identifier
1609919505
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
WOODBURY COUNTY GOVERNMENT
Doing business as
Siouxland District Health Department
Practice address
1014 Nebraska St
Sioux City, IA 51105-1435
Phone
(712) 279-6119
Fax
(712) 255-2677
NPI assigned
Feb 14, 2007
Last updated
Aug 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Authorized official

Name
Kevin R Grieme, MS, BS
Title
Health Director
Phone
(712) 279-6119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

1014 Nebraska St
Sioux City, IA 51105-1435

Mailing address

1014 Nebraska St
Sioux City, IA 51105-1435
Phone (712) 279-6119

Other identifiers 1

IdentifierTypeStateIssuer
0211090MedicaidIA

Other names 1

  • Siouxland District Health Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130405000244 IA Part B Supplier - Mass Immunization (Roster Biller Only) 2769391762 Practice locations: Sioux City, IA

National Provider Directory

National Provider Directory
Tax ID family
Woodbury County Government11 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

1014 Nebraska St
#H
Sioux City, IA 51105

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1609919505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 NEBRASKA ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511051435",
            "telephone_number": "712-279-6119",
            "fax_number": "712-255-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 NEBRASKA ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511051435",
            "telephone_number": "712-279-6119",
            "fax_number": "712-255-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBURY COUNTY GOVERNMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "GRIEME",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "712-279-6119",
        "authorized_official_credential": "MS, BS"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0211090",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Siouxland District Health Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Siouxland District Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.