NPIMap

Organization Active NPI

Palmer Lutheran Health Center, Inc.

  • Critical Access Hospital
  • West Union, IA
National Provider Identifier
1891744108
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
330070H Issued in IA
Legal business name
PALMER LUTHERAN HEALTH CENTER, INC.
Practice address
112 Jefferson Street
West Union, IA 52175
Phone
(563) 422-3811
Fax
(563) 422-9875
NPI assigned
May 6, 2006
Organization subpart
Yes
Parent organization
GUNDERSEN LUTHERAN HEALTH SYSTEM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Authorized official

Name
Ms. Patrice Kuennen
Title
Ceo
Phone
(563) 422-3811

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 330070H IA
Critical Access Hospital 282NC0060X 330070H IA Primary

Addresses

Primary practice location

112 Jefferson Street
West Union, IA 52175

Mailing address

112 Jefferson Street
West Union, IA 52175
Phone (563) 422-3811

Other identifiers 3

IdentifierTypeStateIssuer
0090423MedicaidIA
13603OtherIABLUE CROSS ER GROUP
90423MedicaidIA

Other names 1

  • Gundersen Palmer Lutheran Hospital and Clinics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040317001077 IA Part B Supplier - Clinic/Group Practice 4284544255 Receives reassigned benefits from 173 practitioners
1 other NPI on this enrollment
Practice locations: West Union, IA; Postville, IA; Fayette, IA
O20170127002157 WI Part B Supplier - Clinic/Group Practice 4284544255 Receives reassigned benefits from 70 practitioners
Practice locations: Black River Falls, WI; La Crosse, WI; Onalaska, WI; Viroqua, WI; Whitehall, WI

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

220 N Industrial Pkwy
West Union, IA 52175
Phone (563) 422-6067

Practitioners & affiliated clinicians

Practitioners 229

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 229

NPI Registry JSON

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1891744108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 JEFFERSON STREET",
            "city": "WEST UNION",
            "state": "IA",
            "postal_code": "52175",
            "telephone_number": "563-422-3811",
            "fax_number": "563-422-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 JEFFERSON STREET",
            "city": "WEST UNION",
            "state": "IA",
            "postal_code": "52175",
            "telephone_number": "563-422-3811",
            "fax_number": "563-422-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMER LUTHERAN HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUNDERSEN LUTHERAN HEALTH SYSTEM, INC.",
        "enumeration_date": "2006-05-06",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "KUENNEN",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-422-3811",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "330070H",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IA",
            "license": "330070H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0090423",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ER GROUP",
            "identifier": "13603",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90423",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gundersen Palmer Lutheran Hospital and Clinics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gundersen Palmer Lutheran Hospital and Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Union, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.

Verify at the official NPI Registry.