NPIMap

Organization Active NPI

Iowa Specialty Hospital- Clarion

  • Critical Access Hospital
  • Clarion, IA
National Provider Identifier
1821045451
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
990177H Issued in IA
Legal business name
IOWA SPECIALTY HOSPITAL- CLARION
Practice address
1316 S Main St
Clarion, IA 50525-2019
Phone
(515) 532-2811
Fax
(515) 532-9336
NPI assigned
May 28, 2006
Last updated
Jan 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Authorized official

Name
Steve Simonin
Title
Ceo
Phone
(515) 532-9336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 990177H IA Primary

Addresses

Primary practice location

1316 S Main St
Clarion, IA 50525-2019

Mailing address

1316 S Main St
Clarion, IA 50525-2019
Phone (515) 532-2811

Other identifiers 1

IdentifierTypeStateIssuer
60046OtherIAWELLMARK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070213000457 IA Part A Provider - Critical Access Hospital 3375451347 Receives reassigned benefits from 190 practitioners
Practice locations: Clarion, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821045451. Details of each certification follow.

Hospital certification: CCN 161302

Legal name
IOWA SPECIALTY HOSPITAL- CLARION
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 1, 2000
Last certification
Aug 19, 2019
Beds
25
Ownership / control type
Local
Organization structure
OtherNon-profit
Enrollment address
1316 S Main St
Clarion, IA 50525-2019
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Iowa Specialty Hospital - ClarionCCN 161302 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Ia Specialty Hosp-Clarion22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

1316 S Main St
Ste 2500
Clarion, IA 50525

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
Gregory C Polzin Individual Corporate Director Oct 4, 2013
Iowa Specialty Hospital- Clarion Organization, Clarion, IA Non-profit Operational/Managerial Control Jan 1, 2000 100%
Sherri Obrien Individual Corporate Director Jun 29, 2021
Katrina Stecher Individual Corporate Director Feb 13, 2007
Judith a Ritter Individual Corporate Director Feb 13, 2007
Missy Brannick Individual W-2 Managing Employee Oct 11, 2017
Sue Martin Individual Corporate Director Oct 7, 2013
Steven J Simonin Individual Corporate Officer Nov 19, 2013
Anthony Meinke Individual Corporate Director Oct 29, 2019
Kelly J Leu Individual W-2 Managing Employee Oct 11, 2017

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Iowa Specialty Hospital-ClarionClarion, IA, CCN 16Z302 Hospital Operational/Managerial Control (100%) Jan 1, 2000
Fort Dodge ClinicFort Dodge, IA, CCN 168644 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2000

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 208

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.

View all 208

Affiliated clinicians 84

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 84

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1821045451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 S MAIN ST",
            "city": "CLARION",
            "state": "IA",
            "postal_code": "505252019",
            "telephone_number": "515-532-2811",
            "fax_number": "515-532-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 S MAIN ST",
            "city": "CLARION",
            "state": "IA",
            "postal_code": "505252019",
            "telephone_number": "515-532-2811",
            "fax_number": "515-532-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA SPECIALTY HOSPITAL- CLARION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "SIMONIN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-532-9336"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IA",
            "license": "990177H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "60046",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarion, IA

Sources for this page

Verify at the official NPI Registry.