Boone County Hospital
Organization Active NPI Registered Nurse · Boone, IA
NPI 1619017282 · NPPES record last updated Mar 9, 2023
Key facts
- NPI
- 1619017282
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Registered Nurse 163W00000X
- Legal business name
- BOONE COUNTY HOSPITAL
- Practice address
- 1015 Union St
Boone, IA 50036-4821 - Phone
- (515) 432-3140
- NPI assigned
- Feb 6, 2007
- Organization subpart
- No
Authorized official
- Name
- Mikaela Kienitz
- Title
- Ceo
- Phone
- (515) 432-3140
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 6
Practitioners 43
-
Anna Allen, DNP, ARNP, FNP-C
-
Damiun Bassandeh, CRNA
-
Abby Bennett, DNP
-
Genev J Calek, CRNA
-
Kayla Lea Campbell, CRNA
-
Maribel Castellanos, FNP-C
-
Nicole Chisum, NP
-
Briles Christenson, PA-C
-
Rebecca Sue Clark, CRNA, MS, BSN
-
Michelle R Collette, ARNP
-
Devi Dunker, D.O.
-
Stephen Eckstat, DO
-
Timothy L Evert, DO
-
Christina Goebel, MD
-
Haydee G Hernandez, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Boone Co Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse |
163W00000X | Yes |
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
- Boone County Hospital CRNA
Other providers in Boone, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.