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Organization Active NPI

Pocahontas Community Hospital

  • Critical Access Hospital
  • Pocahontas, IA
National Provider Identifier
1609989581
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
760133H Issued in IA
Legal business name
POCAHONTAS COMMUNITY HOSPITAL
Practice address
606 NW 7TH St
Pocahontas, IA 50574-1028
Phone
(712) 335-3501
Fax
(712) 335-4116
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Lynne A Raveling
Title
Cfo
Phone
(712) 335-3501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 760133H IA Primary

Addresses

Primary practice location

606 NW 7TH St
Pocahontas, IA 50574-1028

Mailing address

606 NW 7TH St
Pocahontas, IA 50574-1028
Phone (712) 335-3501

Other identifiers 2

IdentifierTypeStateIssuer
12752OtherIABC GROUP BILLING NUMBER
116053MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000417 IA Part B Supplier - Clinic/Group Practice 7012820012 Receives reassigned benefits from 52 practitioners
Practice locations: Pocahontas, IA

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Pocahontas Community Hospital5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

608 NW 7th St
Ste D
Pocahontas, IA 50574
Phone (712) 335-3430

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Pocahontas Community HospitalPocahontas, IA, CCN 161305 Hospital Other Jul 1, 1967

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 52

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

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609989581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 NW 7TH ST",
            "city": "POCAHONTAS",
            "state": "IA",
            "postal_code": "505741028",
            "telephone_number": "712-335-3501",
            "fax_number": "712-335-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 NW 7TH ST",
            "city": "POCAHONTAS",
            "state": "IA",
            "postal_code": "505741028",
            "telephone_number": "712-335-3501",
            "fax_number": "712-335-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCAHONTAS COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAVELING",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "712-335-3501",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IA",
            "license": "760133H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC GROUP BILLING NUMBER",
            "identifier": "12752",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116053",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocahontas, IA

Sources for this page

Verify at the official NPI Registry.