NPIMap

Organization Active NPI

Delaware County Memorial Hospital

Doing business as Regional Medical Center

  • Critical Access Hospital
  • Manchester, IA
National Provider Identifier
1881657948
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
DELAWARE COUNTY MEMORIAL HOSPITAL
Doing business as
Regional Medical Center
Practice address
709 W Main St
Manchester, IA 52057-1526
Phone
(563) 927-3232
Fax
(563) 927-7577
NPI assigned
Apr 10, 2006
Last updated
Sep 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Authorized official

Name
Dr. Lon Butikofer, RN, PHD
Title
Ceo
Phone
(563) 927-3232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

709 W Main St
Manchester, IA 52057-1526

Mailing address

709 W Main St
Manchester, IA 52057-1526
Phone (563) 927-3232

Other identifiers 2

IdentifierTypeStateIssuer
0655720MedicaidIA
66009OtherIABCIA

Other names 1

  • Regional Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070129000222 IA Part A Provider - Critical Access Hospital 2062316375 Practice locations: Manchester, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881657948. Details of each certification follow.

Hospital certification: CCN 16Z343

Legal name
DELAWARE COUNTY MEMORIAL HOSPITAL
Doing business as
REGIONAL MEDICAL CENTER
Organization structure
GovernmentNon-profit
Enrollment address
709 W Main St
PO Box 359
Manchester, IA 52057-1526
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
DCMH Anesthesia12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

8833 Monterey Rd
Ste F
Gilroy, CA 95020
Phone (408) 729-2900

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kathy Swift Individual Corporate DirectorBoard Member Jan 2, 2023
John Zietlow Individual Corporate DirectorBoard Member Aug 19, 2024 100%
Delaware County Memorial Hospital Organization, Manchester, IA Non-profit Operational/Managerial Control Aug 28, 2013
Jane Candace Sherman Individual Corporate DirectorBoard Member Jan 2, 2023
Cathy Lilienthal Individual Corporate DirectorBoard Member Sep 18, 2017
Steve H Palmer Individual Corporate DirectorBoard Member Jun 1, 2004
Danette R Kramer Individual Corporate OfficerCfo and Interim Ceo Jan 18, 2021 100%
Corporate DirectorCfo and Interim Ceo Jan 18, 2021 100%
W-2 Managing EmployeeCfo Jan 18, 2021
Joe D Keith Individual Corporate DirectorBoard Member Jan 2, 2001
Chris Tegeler Individual Corporate DirectorBoard Member Jul 1, 2008

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Regional Medical CenterManchester, IA, CCN 161343 Hospital Operational/Managerial Control Aug 28, 2013
Regional Family Health EdgewoodEdgewood, IA, CCN 168531 Rural health clinic Operational/Managerial Control Jan 1, 1966
Regional Family Health HopkintonHopkinton, IA, CCN 168529 Rural health clinic Operational/Managerial Control Apr 1, 2009
Regional Family Health ManchesterManchester, IA, CCN 168530 Rural health clinic Operational/Managerial Control (100%) Apr 1, 2009
Regional Family Health Strawberry PointStrawberry Point, IA, CCN 168528 Rural health clinic Operational/Managerial Control Apr 1, 2009
Regional Family Health WinthropWinthrop, IA, CCN 168554 Rural health clinic Operational/Managerial Control (100%) Aug 1, 1966

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 20

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 20

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1881657948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571526",
            "telephone_number": "563-927-3232",
            "fax_number": "563-927-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571526",
            "telephone_number": "563-927-3232",
            "fax_number": "563-927-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "BUTIKOFER",
        "authorized_official_first_name": "LON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-927-3232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "RN, PHD"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0655720",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCIA",
            "identifier": "66009",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, IA

Sources for this page

Verify at the official NPI Registry.