NPIMap

Organization Active NPI

Boone County Hospital

Doing business as Boone County Hospital CRNA

  • Registered Nurse
  • Boone, IA
National Provider Identifier
1619017282
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Legal business name
BOONE COUNTY HOSPITAL
Doing business as
Boone County Hospital CRNA
Practice address
1015 Union St
Boone, IA 50036-4821
Phone
(515) 432-3140
NPI assigned
Feb 6, 2007
Last updated
Mar 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Authorized official

Name
Mikaela Kienitz
Title
Ceo
Phone
(515) 432-3140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X Primary

Addresses

Primary practice location

1015 Union St
Boone, IA 50036-4821

Mailing address

1015 Union St
Boone, IA 50036-4821
Phone (515) 432-3140

Other names 1

  • Boone County Hospital CRNA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204001048 IA Part B Supplier - Clinic/Group Practice 7416840335 Receives reassigned benefits from 42 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boone, IA; Ogden, IA

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Cardiology Assoc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 43

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 43

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1619017282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 UNION ST",
            "city": "BOONE",
            "state": "IA",
            "postal_code": "500364821",
            "telephone_number": "515-432-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 UNION ST",
            "city": "BOONE",
            "state": "IA",
            "postal_code": "500364821",
            "telephone_number": "515-432-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONE COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "KIENITZ",
        "authorized_official_first_name": "MIKAELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-432-3140"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boone County Hospital CRNA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Boone County Hospital CRNA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boone, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.