NPIMap

Organization Active NPI

Clarinda Regional Health Center

  • Family Medicine Physician
  • Clarinda, IA
National Provider Identifier
1629196241
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLARINDA REGIONAL HEALTH CENTER
Practice address
220 Essie Davison Dr.
Clarinda, IA 51632-2915
Phone
(712) 542-8330
Fax
(712) 542-8397
NPI assigned
Mar 26, 2007
Organization subpart
Yes
Parent organization
CLARINDA REGIONAL HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Authorized official

Name
Elaine K Otte
Title
Coo
Phone
(712) 542-2176

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

220 Essie Davison Dr.
Clarinda, IA 51632-2915

Mailing address

PO Box 217
Clarinda, IA 51632-0217
Phone (712) 542-8305

Other names 1

  • Clarinda Medical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031205000207 IA Part B Supplier - Clinic/Group Practice 4587573993 Receives reassigned benefits from 149 practitioners
1 other NPI on this enrollment
Practice locations: Atlantic, IA; Villisca, IA; Sidney, IA; Red Oak, IA; Hamburg, IA; Clarinda, IA; Bedford, IA
O20210218000678 NE Part B Supplier - Clinic/Group Practice 4587573993 Receives reassigned benefits from 2 practitioners
Practice locations: Pender, NE

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Clarinda Regional Center

Locations

303 Pearl St
Bedford, IA 50833
Phone (712) 523-1146

200 Essie Davison Dr
Clarinda, IA 51632

400 W Glenn Miller Dr
Clarinda, IA 51632
Phone (712) 542-8354

Practitioners & affiliated clinicians

Practitioners 155

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

View all 155

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400630400000",
    "number": "1629196241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 217",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516320217",
            "telephone_number": "712-542-8305",
            "fax_number": "712-542-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 ESSIE DAVISON DR.",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516322915",
            "telephone_number": "712-542-8330",
            "fax_number": "712-542-8397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARINDA REGIONAL HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLARINDA REGIONAL HEALTH CENTER",
        "enumeration_date": "2007-03-26",
        "last_updated": "2014-05-21",
        "status": "A",
        "authorized_official_last_name": "OTTE",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "712-542-2176"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarinda Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarinda, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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.