St Anthony Regional Hospital and Nursing Home
Organization Active NPI Family Medicine Physician · Carroll, IA
NPI 1801815972 · NPPES record last updated Sep 10, 2015
Key facts
- NPI
- 1801815972
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME
- Practice address
- 311 S Clark St
Carroll, IA 51401-3038 - Phone
- (712) 792-2222
- Fax
- (712) 792-3875
- NPI assigned
- Jul 19, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME
Authorized official
- Name
- John Munson
- Title
- Cfo
- Phone
- (712) 794-5115
Owned or controlled facilities with NPI records 4
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 7
Practitioners 133
-
Debra Marie Adams, ARNP
-
Robert J Behrens, MD
-
Jessica Marie Borkowski, ARNP, FNP-C
-
Christie Marie Burnell, PMHNP-BC
-
Jacqueline L. Crampton, ARNP
-
Rachael Dirkx, PA-C
-
Cassie Ann Esdohr, PA-C
-
Kendra Rita Freese, ARNP
-
Richard B. Goding, M.D.
-
Jedd A Hagen, MD
-
Christopher M Hanson, CRNA
-
Michelle Marie Kroeger, ARNP, MSN
-
Mikala Anne Landon, ARNP
-
Jason Troy Lihs, CRNA
-
Joshua C Lukenbill, D.O.
-
Walter Mogeni, MD
-
Jason Mohr, DO
-
Jennifer Diane Pavlisin, ARNP
-
Derae Audra Schroeder, DNP, ARNP
-
Brooke Victoria Scott, ARNP
-
Bridget Marie Shariat, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| BCG Data Services |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Jul 1, 2025 Jul 1, 2025 Jul 1, 2025 |
| St Anthony Regional Hospital & Nursing Home |
Home health agency | Operational/Managerial Control | Nov 1, 1997 |
| St Anthony Regional Hospital and Nursing Home |
Hospice | Operational/Managerial Control | Nov 1, 1997 |
| St Anthony Regional Hospital and Nursing Home |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Sep 28, 1904 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031105000218 | IA | Part B Supplier - Clinic/Group Practice | 4688586829 |
Receives reassigned benefits from 130 practitioners 3 other NPIs on this enrollment Practice locations: Atlantic, IA; Carroll, IA; Denison, IA; Humboldt, IA; Pocahontas, IA; Storm Lake, IA |
National Provider Directory
- Part of
- St Anthony Reg Hsptl Nrnsg
Locations
221 Main St
Breda, IA 51436
Phone (712) 673-2301
311 S Clark St
Fl 4
Carroll, IA 51401
Phone (712) 794-5435
318 S Maple St
Ste 2
Carroll, IA 51401
Phone (712) 794-5279
1820 Highway 30 E
Denison, IA 51442
Phone (712) 263-6116
1000 W Lincoln Way
Jefferson, IA 50129
Phone (515) 386-2114
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
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) 792-2222
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0276493 | Medicaid | IA |
Other names
- St Anthony Regional Hospital Clinic
Other providers in Carroll, IA
- St Anthony Regional Hospital and Nursing Home
- St Anthony Regional Hospital and Nursing Home
- St Anthony Regional Hospital and Nursing Home
- St Anthony Regional Hospital and Nursing Home
- St Anthony Regional Hospital and Nursing Home
- St Anthony Regional Hospital and Nursing Home
- St Anthony Regional Hospital and Nursing Home
- St Anthony Senior Services LLC
- St Anthony Senior Services LLC
- St. Anthony Regional Hospital and Nursing Home
All providers in Carroll, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.