NPIMap

Organization Active NPI

Washington County Hospital

Doing business as Washington County Hospital and Clinics Family Medicine

  • Rural Health Clinic/Center
  • Washington, IA
National Provider Identifier
1669802955
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WASHINGTON COUNTY HOSPITAL
Doing business as
Washington County Hospital and Clinics Family Medicine
Practice address
1230 S Iowa Ave
Washington, IA 52353-1144
Phone
(319) 653-7291
NPI assigned
Nov 22, 2013
Last updated
Jan 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Authorized official

Name
Mr. Todd Patterson
Title
Ceo
Phone
(319) 863-3901

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

1230 S Iowa Ave
Washington, IA 52353-1144

Mailing address

PO Box 909
1230 S. Iowa Avenue
Washington, IA 52353-0909
Phone (319) 653-7291

Other identifiers 2

IdentifierTypeStateIssuer
16D0386746OtherIACLIA
16-8567OtherIAMEDICARE PTAN

Other names 1

  • Washington County Hospital and Clinics Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031226000310 IA Part B Supplier - Clinic/Group Practice 2062329931 Receives reassigned benefits from 90 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Washington, IA; Kalona, IA
O20141110000263 IA Part A Provider - Rural Health Clinic 2062329931 Practice locations: Washington, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669802955. Details of each certification follow.

Rural health clinic certification: CCN 168567

Legal name
WASHINGTON COUNTY HOSPITAL
Doing business as
WASHINGTON COUNTY HOSPITAL AND CLINICS FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 29, 2015
Last certification
Jun 6, 2018
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Enrollment address
1230 South Iowa Ave
Box 909
Washington, IA 52353-1144
Related CCNs
161344

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

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

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
Washington Co Hosp Emer8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

1230 S Iowa Ave
Washington, IA 52353
Phone (319) 653-4271

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Edward R Weeks Individual Corporate DirectorHospital Trustee Apr 27, 2023
Washington County Hospital Organization, Washington, IA Non-profit 5% Or Greater Direct Ownership Interest Mar 1, 2014 100%
Philip Roudabush Individual Corporate OfficerChief Transformation Officer May 20, 2024
W-2 Managing EmployeeChief Transformation Officer May 20, 2024
Sue Basten Individual Corporate DirectorHospital Trustee Jan 1, 2019
David Mitchell Individual Corporate DirectorHospital Trustee Sep 17, 2021
Michael Driscoll Individual Corporate DirectorHospital Trustee Jan 1, 2021
David Bruns Individual Corporate Director Jan 1, 2015
Mike Vanosdol Individual Corporate DirectorHospital Trustee Jan 1, 2015
Todd Patterson Individual Corporate OfficerCeo Apr 2, 2018
W-2 Managing EmployeeCeo Apr 2, 2018
Andrea Leyden Individual Corporate OfficerChief Nursing Officer Jan 27, 2006
W-2 Managing Employee Jan 27, 2006
Stephan J Schomer Individual Corporate OfficerChief Medical Officer Mar 30, 2015
W-2 Managing EmployeeChief Medical Officer Mar 30, 2015
Mary Cathy Rich Individual Corporate DirectorHospital Trustee Mar 1, 2026
Michelle M Cleverley Individual Corporate OfficerChief Financial Officer Jan 1, 2017
W-2 Managing EmployeeChief Financial Officer Sep 1, 2017

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Washington County Hospital and ClinicsWashington, IA, CCN 16Z344 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2002
Washington County Hospital and Clinics McCreedy Medical ClinicWashington, IA, CCN 168568 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2007
Washington County Hospital and Clinics Columbus Junction ClinicColumbus Junction, IA, CCN 168654 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2021
WCHC Mediapolis ClinicMediapolis, IA, CCN 168674 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2025

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578441600000",
    "number": "1669802955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "address_2": "1230 S. IOWA AVENUE",
            "city": "WASHINGTON",
            "state": "IA",
            "postal_code": "523530909",
            "telephone_number": "319-653-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 S IOWA AVE",
            "city": "WASHINGTON",
            "state": "IA",
            "postal_code": "523531144",
            "telephone_number": "319-653-7291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-863-3901",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "16D0386746",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "16-8567",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington County Hospital and Clinics Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Washington County Hospital and Clinics Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, IA

Sources for this page

Verify at the official NPI Registry.