NPIMap

Organization Active NPI

Cass County Memorial Hospital

Doing business as Atlantic Medical Center

  • Rural Health Clinic/Center
  • Atlantic, IA
National Provider Identifier
1699976696
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CASS COUNTY MEMORIAL HOSPITAL
Doing business as
Atlantic Medical Center
Practice address
1501 E 10TH St
Ste 100, 105 & 120
Atlantic, IA 50022-1936
Phone
(712) 243-2850
Fax
(712) 243-7423
NPI assigned
May 29, 2007
Last updated
Jan 16, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CASS COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Authorized official

Name
Abbey Stangl
Title
Chief Financial Officer
Phone
(712) 243-7804

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Durable Medical Equipment & Medical Supplies 332B00000X
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

1501 E 10TH St
Ste 100, 105 & 120
Atlantic, IA 50022-1936

Mailing address

1501 E 10TH St
Atlantic, IA 50022-1936
Phone (712) 243-2850

Other identifiers 1

IdentifierTypeStateIssuer
1699976696MedicaidIA

Other names 1

  • ATLANTIC MEDICAL CENTER Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031231000681 IA Part B Supplier - Clinic/Group Practice 5294634994 Receives reassigned benefits from 126 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anita, IA; Atlantic, IA; Clarinda, IA; Griswold, IA; Massena, IA; Red Oak, IA
O20070605000205 IA Part A Provider - Rural Health Clinic 5294634994 Practice locations: Atlantic, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699976696. Details of each certification follow.

Rural health clinic certification: CCN 168523

Legal name
CASS COUNTY MEMORIAL HOSPITAL
Doing business as
ATLANTIC MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 1, 2007
Last certification
Aug 3, 2021
Ownership / control type
2B
Organization structure
OtherNon-profit
Enrollment address
1501 E 10TH St
Ste 100, 105 & 120
Atlantic, IA 50022-1936
Related CCNs
161376

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

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Part of
Cass County Hospital

Locations

1501 E 10th St
Ste 100105
Atlantic, IA 50022

1501 E 10th St
Ste 200
Atlantic, IA 50022
Phone (712) 243-7540

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Brett a Altman Individual Corporate OfficerCeo Jan 3, 2017
W-2 Managing EmployeeCeo Jan 3, 2017
Operational/Managerial ControlCeo Jan 3, 2017
Nathan Brown Individual Corporate Director Mar 24, 2009
Linda Pelzer Individual Corporate Director Nov 20, 2019
Julia Ann Pollock Individual Corporate Director Jan 1, 2013
Kolton E Hewlett Individual Corporate OfficerCfo Dec 30, 2023
W-2 Managing EmployeeCfo Dec 30, 2023
Elaine K Berry Individual W-2 Managing EmployeeMD; Aug 1, 2021
Joanne Lorence Individual Corporate Director Jul 20, 2016
Leanne Pellett Individual Corporate Director Jan 1, 2009
Roger Lynn Herring Individual Corporate Director Jan 1, 2013
Michael John Klocke Individual Corporate Director Jan 1, 2017

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Griswold Medical CenterGriswold, IA, CCN 168525 Rural health clinic Operational/Managerial Control May 25, 2007
Massena Medical CenterMassena, IA, CCN 168524 Rural health clinic Operational/Managerial Control May 25, 2007
Anita Medical CenterAnita, IA, CCN 168526 Rural health clinic Operational/Managerial Control May 25, 2007

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1699976696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E 10TH ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221936",
            "telephone_number": "712-243-2850",
            "fax_number": "712-243-7423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E 10TH ST",
            "address_2": "STE 100, 105 & 120",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221936",
            "telephone_number": "712-243-2850",
            "fax_number": "712-243-7423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASS COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CASS COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2007-05-29",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "STANGL",
        "authorized_official_first_name": "ABBEY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "712-243-7804"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699976696",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATLANTIC MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlantic, IA

Sources for this page

Verify at the official NPI Registry.