Iowa Specialty Hospital- Clarion
Organization Active NPI Critical Access Hospital · Clarion, IA
NPI 1821045451 · NPPES record last updated Jan 20, 2020
Key facts
- NPI
- 1821045451
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 990177H (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
- Organization subpart
- No
Authorized official
- Name
- Steve Simonin
- Title
- Ceo
- Phone
- (515) 532-9336
Owners & managing parties with NPI records 5
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 21
Related certifications (CCN) 4
Facilities with the same owner 2
Practitioners 221
-
Christopher Edelen Adams, M.D.
-
Kenneth W Adams, D.O.
-
Jon S Ahrendsen, M.D.
-
Carla Louise Aldrich, CRNA
-
Adam R Andrews, D.O.
-
Monique Bailey, ARNP
-
Kaitlen Baker, MD
-
Trisha Ann Bartlett, PA-C
-
Damiun Bassandeh, CRNA
-
Benjamin Becker, P.A.
-
Robert E Berg, MD
-
Jacob Boll, CRNA
-
Matthew D Danilson, PA- C
-
Kristen Kay Davison, PA-C
-
Nicole Faye Dennler, ARNP
-
Jaclyn Marie Dohlman, ARNP
-
Chrysten Rae Dohrmann, ARNP
-
Jayme Dougherty, FNP-C
-
Amy Faga, ARNP
Affiliated clinicians 84
-
Christopher Edelen Adams, M.D.
-
Kenneth W Adams, D.O.
-
Jon S Ahrendsen, M.D.
-
Carla Louise Aldrich, CRNA
-
Adam R Andrews, D.O.
-
Kaitlen Baker, MD
-
Trisha Ann Bartlett, PA-C
-
Damiun Bassandeh, CRNA
-
Benjamin Becker, P.A.
-
Jacob Boll, CRNA
-
Amber Lee Campbell, APRN
-
Matthew D Danilson, PA- C
-
Kristen Kay Davison, PA-C
-
Nicole Faye Dennler, ARNP
-
Renee Diamond, M.D.
-
Chrysten Rae Dohrmann, ARNP
-
Jayme Dougherty, FNP-C
-
Rachael D Etnier, DO
-
Amy Faga, ARNP
-
Monica Forbes, PA-C
Medicare Care Compare: Hospital
- Listed as
- Iowa Specialty Hospital - Clarion
- Type
- Critical Access Hospitals
- Ownership
- Government - Local
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
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
- Other · Non-profit
- Enrollment address
- 1316 S Main St
Clarion, IA 50525-2019
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Gregory C Polzin |
Corporate Director | Oct 4, 2013 | |
| Iowa Specialty Hospital- Clarion |
Operational/Managerial Control | Jan 1, 2000 | 100% |
| Sherri Obrien |
Corporate Director | Jun 29, 2021 | |
| Katrina Stecher |
Corporate Director | Feb 13, 2007 | |
| Judith a Ritter |
Corporate Director | Feb 13, 2007 | |
| Missy Brannick |
W-2 Managing Employee | Oct 11, 2017 | |
| Sue Martin |
Corporate Director | Oct 7, 2013 | |
| Steven J Simonin |
Corporate Officer | Nov 19, 2013 | |
| Anthony Meinke |
Corporate Director | Oct 29, 2019 | |
| Kelly J Leu |
W-2 Managing Employee | Oct 11, 2017 |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Iowa Specialty Hospital-Clarion |
Hospital | Operational/Managerial Control (100%) | Jan 1, 2000 |
| Fort Dodge Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Jan 1, 2000 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070213000457 | IA | Part a Provider - Critical Access Hospital | 3375451347 |
Receives reassigned benefits from 190 practitioners Practice locations: Clarion, IA |
National Provider Directory
- Tax ID family
- Iowa Specialty Hospital- Clarion
Locations
1111 Willow Dr
Clarion, IA 50525
Phone (515) 532-2648
1316 S Main St
Ste 2500
Clarion, IA 50525
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 990177H | IA | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60046 | Other | IA | WELLMARK |
Other providers in Clarion, IA
- Iowa Specialty Hospital- Clarion
- Iowa Specialty Hospital- Clarion
- Iowa Specialty Hospital- Clarion
- Iowa Specialty Hospital- Clarion
- Iowa Specialty Hospital- Clarion
- Iowa Specialty Hospital- Clarion
- Iowa Specialty Hospital- Clarion
- Iowa Specialty Hospital-Clarion
- Iowa Specialty Hospital-Clarion
- Iowa Specialty Hospital-Clarion
All providers in Clarion, IA · Critical Access Hospital in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2020. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.