Active NPI
Montgomery County Memorial Hospital
- Certified Registered Nurse Anesthetist
- Red Oak, IA
National Provider Identifier
1811960867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- Legal business name
- MONTGOMERY COUNTY MEMORIAL HOSPITAL
- Practice address
- 2301 Eastern Ave
Red Oak, IA 51566-1305 - Phone
- (712) 623-7000
- Fax
- (712) 623-7224
- NPI assigned
- Feb 9, 2006
- Last updated
- Apr 21, 2009
- Organization subpart
- Yes
- Parent organization
- MONTGOMERY COUNTY MEMORIAL HOSPITAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Allen E. Pohren
- Title
- Ceo
- Phone
- (712) 623-7000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | Primary |
Addresses
Primary practice location
2301 Eastern Ave
Red Oak, IA 51566-1305
Mailing address
PO Box 498
Red Oak, IA 51566-0498
Phone (712) 623-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26870 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031211000423 | IA | Part B Supplier - Clinic/Group Practice | 9032015805 |
Receives reassigned benefits from 78 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Malvern, IA; Villisca, IA; Stanton, IA; Shenandoah, IA; Red Oak, IA; Clarinda, IA; Atlantic, IA |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Internal Medicine Physician
- Red Oak, IA
- NPI 1265405310
O20031211000423
National Provider Directory
National Provider Directory- Part of
- Montogomery Co Mem Hosp
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139443200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1240272000000",
"number": "1811960867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 498",
"city": "RED OAK",
"state": "IA",
"postal_code": "515660498",
"telephone_number": "712-623-7000",
"fax_number": "712-623-7224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 EASTERN AVE",
"city": "RED OAK",
"state": "IA",
"postal_code": "515661305",
"telephone_number": "712-623-7000",
"fax_number": "712-623-7224"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MONTGOMERY COUNTY MEMORIAL HOSPITAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MONTGOMERY COUNTY MEMORIAL HOSPITAL",
"enumeration_date": "2006-02-09",
"last_updated": "2009-04-21",
"status": "A",
"authorized_official_last_name": "POHREN",
"authorized_official_first_name": "ALLEN",
"authorized_official_middle_name": "E.",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "712-623-7000",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "26870",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Red Oak, IA
- Montgomery County Memorial Hospital (Women's Health Center)
- Montgomery County Memorial Hospital
- Montgomery County Memorial Hospital
- Montgomery County Memorial Hospital (MCMH Pharmacy)
- Montgomery County Memorial Hospital (Heartland Home Health)
- Montgomery County Memorial Hospital
- Montgomery County Memorial Hospital (Montgomery County Memorial Hospital DME)
- Montgomery County Memorial Hospital (Red Oak Medical Clinic)
- Martin Damien Mulligan
- Etta Murphy, LMHC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.