NPIMap

Organization Active NPI

Jackson County Public Hospital

Doing business as Jackson County Regional Health Center

  • Critical Access Hospital
  • Maquoketa, IA
National Provider Identifier
1912960758
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
490099H Issued in IA
Legal business name
JACKSON COUNTY PUBLIC HOSPITAL
Doing business as
Jackson County Regional Health Center
Practice address
601 Hospital Drive
Maquoketa, IA 52060-0910
Phone
(563) 652-2474
Fax
(563) 652-4096
NPI assigned
Apr 11, 2006
Last updated
Mar 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Authorized official

Name
Curt M Coleman
Title
Ceo
Phone
(563) 652-4020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 490099H IA Primary

Addresses

Primary practice location

601 Hospital Drive
Maquoketa, IA 52060-0910

Mailing address

601 Hospital Drive
Maquoketa, IA 52060-0910
Phone (563) 652-2474

Other names 1

  • JACKSON COUNTY REGIONAL HEALTH CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000661 IA Part A Provider - Critical Access Hospital 1254248958 Receives reassigned benefits from 64 practitioners
Practice locations: Maquoketa, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912960758. Details of each certification follow.

Hospital certification: CCN 161329

Legal name
JACKSON COUNTY PUBLIC HOSPITAL
Doing business as
JACKSON COUNTY REGIONAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Nov 1, 2001
Last certification
Oct 6, 2017
Beds
25
Ownership / control type
Local
Organization structure
OtherNon-profit
Incorporated
May 16, 1956 in IA
Enrollment address
601 Hospital Drive
Maquoketa, IA 52060-0910
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Jackson County Regional Health CenterCCN 161329 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Jackson County Public H4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Jackson County Public Hospital Organization, Maquoketa, IA Operational/Managerial Control Feb 7, 2018
Dianne Brady Individual Corporate DirectorBoard Member Apr 1, 2019
Kevin L Burns Individual Corporate DirectorBoard Member May 23, 2000
Elaine Edwards Individual Corporate DirectorBoard Member Apr 1, 2019
Patrick J Peters Individual Contracted Managing EmployeeAdministrator Feb 6, 2023
Corporate DirectorAdministrator Feb 6, 2023
William Schwenker Individual Corporate DirectorBoard Member Jul 1, 2019
Debra K Renner Individual Corporate DirectorBoard Member Jan 1, 2023
Mercy Health Network Inc Organization, Clive, IA Corporation, Non-profit Operational/Managerial Control Sep 1, 2023 100%
James Thines Individual Corporate DirectorBoard Member Oct 1, 2019
Matthew Osterhaus Individual Corporate DirectorBoard Member Jul 1, 2016
Kolin Huth Individual Corporate DirectorCfo Mar 15, 2023
W-2 Managing EmployeeCfo Mar 15, 2023

Owners & managing parties with NPI records 2

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

Facilities with the same owner 98

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

View all 98

Practitioners & affiliated clinicians

Practitioners 73

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 73

Affiliated clinicians 123

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

View all 123

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1912960758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HOSPITAL DRIVE",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520600910",
            "telephone_number": "563-652-2474",
            "fax_number": "563-652-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HOSPITAL DRIVE",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520600910",
            "telephone_number": "563-652-2474",
            "fax_number": "563-652-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY PUBLIC HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "CURT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-652-4020"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IA",
            "license": "490099H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACKSON COUNTY REGIONAL HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JACKSON COUNTY REGIONAL HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maquoketa, IA

Sources for this page

Verify at the official NPI Registry.