NPIMap

Organization Active NPI

St. Anthony Regional Hospital and Nursing Home

  • Medicare Defined Swing Bed Hospital Unit
  • Carroll, IA
National Provider Identifier
1902886039
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
140090H Issued in IA
Legal business name
ST. ANTHONY REGIONAL HOSPITAL AND NURSING HOME
Practice address
311 S Clark St
Carroll, IA 51401-3038
Phone
(712) 792-3581
Fax
(712) 792-2124
NPI assigned
Jan 17, 2006
Last updated
Oct 16, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ST ANTHONY REGIONAL HOSPITAL AND NURSING HOMEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Authorized official

Name
Allen Anderson
Title
Ceo
Phone
(712) 794-5025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 140090H IA Primary

Addresses

Primary practice location

311 S Clark St
Carroll, IA 51401-3038

Mailing address

PO Box 628
Carroll, IA 51401-0628
Phone (712) 792-3581

Other identifiers 1

IdentifierTypeStateIssuer
0655415MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240418000360 IA Part A Provider - Critical Access Hospital 4688586829 Practice locations: Carroll, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902886039. Details of each certification follow.

Hospital certification: CCN 16Z382

Legal name
ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME
Doing business as
ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME
Organization structure
CorporationNon-profit
Enrollment address
311 S Clark St
Carroll, IA 51401-3038
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Part of
St Anthony Reg Hosp

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Matthew Greteman Individual Corporate DirectorTreasurer Jul 1, 2024
Jeff Koster Individual Corporate Director Jul 1, 2024
Deb Auen Individual Corporate DirectorVice Chair Jul 1, 2020
Carly M Quam Individual Corporate Director Jan 1, 2025
Michele Pettit Individual Corporate Director Jul 1, 2021
Karl Eischeid Individual Corporate Director Jul 1, 2018
Richard Hunsaker Individual Corporate Director Jul 1, 2025
Rose Elsbernd Individual Corporate DirectorSecretary Jul 1, 2020
Jeff Scharfenkamp Individual Corporate OfficerChairman Jul 1, 2023
Corporate Director Jul 1, 2019
Eric Salmonson Individual W-2 Managing EmployeeVP & Cfo Jul 1, 2022
Operational/Managerial ControlVP & Cfo Jul 1, 2022
John Strautman Individual Corporate Director Jul 1, 2025
Jennifer Wollesen Individual Corporate Director Jul 1, 2025
Joanne Moeller Individual Corporate Director Jul 1, 2023
Allen K Anderson Individual Corporate OfficerPresident/Ceo Jul 1, 2022
W-2 Managing EmployeePresident/Ceo Jul 1, 2022
Operational/Managerial ControlPresident/Ceo Jul 1, 2022

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
BCG Data ServicesCarroll, IA, CCN 165796 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Jul 1, 2025
Jul 1, 2025
Jul 1, 2025
St Anthony Regional Hospital & Nursing HomeCarroll, IA, CCN 167207 Home health agency Operational/Managerial Control Nov 1, 1997
St Anthony Regional Hospital and Nursing HomeCarroll, IA, CCN 161546 Hospice Operational/Managerial Control Nov 1, 1997
St Anthony Regional Hospital and Nursing HomeCarroll, IA, CCN 163400 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 28, 1904

Owned or controlled facilities with NPI records 4

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

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1902886039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 628",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514010628",
            "telephone_number": "712-792-3581",
            "fax_number": "712-792-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S CLARK ST",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013038",
            "telephone_number": "712-792-3581",
            "fax_number": "712-792-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANTHONY REGIONAL HOSPITAL AND NURSING HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME",
        "enumeration_date": "2006-01-17",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "712-794-5025"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "IA",
            "license": "140090H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0655415",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carroll, IA

Sources for this page

Verify at the official NPI Registry.