NPIMap

Organization Active NPI

Crawford County Memorial Hospital

  • Certified Registered Nurse Anesthetist
  • Denison, IA
National Provider Identifier
1699748327
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
CRAWFORD COUNTY MEMORIAL HOSPITAL
Practice address
100 Medical Parkway
Denison, IA 51442-2299
Phone
(712) 265-2500
Fax
(712) 265-2511
NPI assigned
Feb 13, 2006
Organization subpart
Yes
Parent organization
CRAWFORD COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Erin C Muck
Title
President/Ceo
Phone
(712) 265-2506

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X 240173H IA
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

100 Medical Parkway
Denison, IA 51442-2299

Mailing address

100 Medical Parkway
Denison, IA 51442-2299
Phone (712) 265-2500

Other identifiers 2

IdentifierTypeStateIssuer
0266403MedicaidIA
26640OtherIAWELLMARK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040129000821 IA Part B Supplier - Clinic/Group Practice 7810890555 Receives reassigned benefits from 31 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Denison, IA
O20260318004106 TN Part B Supplier - Clinic/Group Practice 7810890555 Receives reassigned benefits from 1 practitioner
Practice locations: Nashville, TN

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 2

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

National Provider Directory

National Provider Directory
Part of
Crawford Co Mem Hosp ER

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

2016 1st Ave S
#202B
Denison, IA 51442
Phone (712) 263-1702

100 Medical Pkwy
Ste Ab
Denison, IA 51442
Phone (712) 265-2700

2016 1st Ave S
Denison, IA 51442
Phone (712) 263-3388

Practitioners & affiliated clinicians

Practitioners 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1699748327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PARKWAY",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "514422299",
            "telephone_number": "712-265-2500",
            "fax_number": "712-265-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PARKWAY",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "514422299",
            "telephone_number": "712-265-2500",
            "fax_number": "712-265-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAWFORD COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRAWFORD COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2006-02-13",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "MUCK",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "712-265-2506"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "240173H",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0266403",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "26640",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.