NPIMap

Organization Active NPI

Humboldt County Memorial Hospital

  • Nursing Facility/Intermediate Care Facility
  • Humboldt, IA
National Provider Identifier
1912089848
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
460155H Issued in IA
Legal business name
HUMBOLDT COUNTY MEMORIAL HOSPITAL
Practice address
1000 15TH St N
Humboldt, IA 50548-1008
Phone
(515) 332-4200
Fax
(515) 332-4820
NPI assigned
Oct 19, 2006
Organization subpart
Yes
Parent organization
HUMBOLDT COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Authorized official

Name
Ms. Heather L. Shaull
Title
Cfo
Phone
(515) 332-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 460155H IA Primary

Addresses

Primary practice location

1000 15TH St N
Humboldt, IA 50548-1008

Mailing address

1000 15TH St N
Humboldt, IA 50548-1008
Phone (515) 332-4200

Other identifiers 1

IdentifierTypeStateIssuer
0807297MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Humboldt Hosp ER Phys7 organizations share this tax ID, including this one
Part of
Humboldt Hosp ER Phys

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1912089848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 15TH ST N",
            "city": "HUMBOLDT",
            "state": "IA",
            "postal_code": "505481008",
            "telephone_number": "515-332-4200",
            "fax_number": "515-332-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 15TH ST N",
            "city": "HUMBOLDT",
            "state": "IA",
            "postal_code": "505481008",
            "telephone_number": "515-332-4200",
            "fax_number": "515-332-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBOLDT COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HUMBOLDT COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2006-10-19",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "SHAULL",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "515-332-4200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IA",
            "license": "460155H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0807297",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Humboldt, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.