NPIMap

Organization Active NPI

Jackson County Public Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Maquoketa, IA
National Provider Identifier
1689705949
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
490099H Issued in IA
Legal business name
JACKSON COUNTY PUBLIC HOSPITAL
Practice address
601 Hospital Drive
Maquoketa, IA 52060-0910
Phone
(563) 652-2474
Fax
(563) 652-4096
NPI assigned
Mar 8, 2007
Last updated
Mar 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Authorized official

Name
Curt Coleman
Title
Ceo
Phone
(563) 652-2474

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PE0004X 490099H IA Primary

Addresses

Primary practice location

601 Hospital Drive
Maquoketa, IA 52060-0910

Mailing address

601 Hospital Drive
Maquoketa, IA 52060-0910
Phone (563) 652-2474

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040120000117 IA Part B Supplier - Clinic/Group Practice 1254248958 Receives reassigned benefits from 43 practitioners
Practice locations: Maquoketa, 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
Jackson County Public H4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

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
Jackson County Regional Health CenterMaquoketa, IA, CCN 161329 Hospital Operational/Managerial Control Feb 7, 2018

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 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1689705949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HOSPITAL DRIVE",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520600910",
            "telephone_number": "563-652-2474",
            "fax_number": "563-652-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HOSPITAL DRIVE",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520600910",
            "telephone_number": "563-652-2474",
            "fax_number": "563-652-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY PUBLIC HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "CURT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-652-2474"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IA",
            "license": "490099H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maquoketa, IA

Sources for this page

Verify at the official NPI Registry.