NPIMap

Organization Active NPI

St Anthony Regional Hospital and Nursing Home

  • Registered Nurse
  • Carroll, IA
National Provider Identifier
1710062088
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Legal business name
ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME
Practice address
311 S Clark St
Carroll, IA 51401-3038
Phone
(712) 792-3581
Fax
(712) 792-2124
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Authorized official

Name
John Munson
Title
Cfo
Phone
(712) 794-5115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X Primary

Addresses

Primary practice location

311 S Clark St
Carroll, IA 51401-3038

Mailing address

311 S Clark St
PO Box 628
Carroll, IA 51401-3038
Phone (712) 792-3581

Other identifiers 1

IdentifierTypeStateIssuer
0267856MedicaidIA

Other names 1

  • ST ANTHONY REGIONAL CRNA GROUP Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000218 IA Part B Supplier - Clinic/Group Practice 4688586829 Receives reassigned benefits from 130 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Atlantic, IA; Carroll, IA; Denison, IA; Humboldt, IA; Pocahontas, IA; Storm Lake, IA

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
St Anthony Reg Hsptl Nrnsg11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

221 Ann St
Manning, IA 51455
Phone (712) 653-2211

235 Highway 30
Westside, IA 51467
Phone (712) 663-4373

Practitioners 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1710062088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S CLARK ST",
            "address_2": "PO BOX 628",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013038",
            "telephone_number": "712-792-3581",
            "fax_number": "712-792-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S CLARK ST",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013038",
            "telephone_number": "712-792-3581",
            "fax_number": "712-792-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "MUNSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "712-794-5115"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0267856",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST ANTHONY REGIONAL CRNA GROUP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carroll, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.