Jackson County Public Hospital
Organization Active NPI Critical Access Hospital · Maquoketa, IA
NPI 1912960758 · NPPES record last updated Mar 8, 2021
Key facts
- NPI
- 1912960758
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 490099H (IA)
- Legal business name
- JACKSON COUNTY PUBLIC HOSPITAL
- Practice address
- 601 Hospital Drive
Maquoketa, IA 52060-0910 - Phone
- (563) 652-2474
- Fax
- (563) 652-4096
- NPI assigned
- Apr 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Curt M Coleman
- Title
- Ceo
- Phone
- (563) 652-4020
Owners & managing parties with NPI records 2
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 3
Related certifications (CCN) 1
Facilities with the same owner 98
Practitioners 73
-
Timothy Paul Becher, CRNA
-
Ashley Renee Caes, ARNP, FNP-C
-
Ryan Taylor Eyberg, CRNA
-
Grant Leroy Forrester, M.D.
-
Meghan Ashley Goodall, CRNA
-
Stephanie Klein, ARNP, CRNA
-
Ann Leland, CRNA
-
Richard Maynard, CRNA
-
Christina Marie Walter, CRNA
-
Jennifer K McClimon, CRNA
-
Adam Randel Osborne, CRNA
-
Ashley Susan Skrocki, CRNA
-
James M. Stecher, M.D.
-
Phillip Gabriel Bailey, M.D.
-
Eric Timothy Hogan, D.O.
-
Amanda Sue River, M.D., M.P.H
-
Jacob Levi Wagner, M.D.
-
Roger R Waller, MD
-
Lisa Ann Davis, MD
-
Ron Elfenbein, MD
Affiliated clinicians 123
-
Grace E Adam, PA-C
-
Anoop Aggarwal, M.D.
-
Deborah Kay Bahe, ARNP
-
Phillip Gabriel Bailey, M.D.
-
Jaffer H Bashey, M.D.
-
Jennifer Lynn Bell, M.D.
-
Thomas James Benda Jr., M.D.
-
Andrew David Bries, M.D.
-
Cynthia D Burkholder, ARNP
-
Jerald W Bybee, MD
-
Ashley Renee Caes, ARNP, FNP-C
-
Irena M Charysz-Birski, M.D.
-
Ryan Cloos, D.O.
-
Edmund P Coyne, M.D.
-
Michael Dolphin, DO
-
Ryan Patrick Dunlay, M.D.
-
Kayla Leigh Ehrman, D.O.
-
Eric S. Engelman, D.O.
-
Kari Jo Ernst, ARNP
-
Ryan Taylor Eyberg, CRNA
-
Grant Leroy Forrester, M.D.
-
Alison Fraehlich, MD
-
Salem T. Gaballa, MBBCH
Medicare Care Compare: Hospital
- Listed as
- Jackson County Regional Health Center
- Type
- Critical Access Hospitals
- Ownership
- Government - Local
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
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
- Other · Non-profit
- Incorporated
- May 16, 1956 in IA
- Enrollment address
- 601 Hospital Drive
Maquoketa, IA 52060-0910
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Jackson County Public Hospital |
Operational/Managerial Control | Feb 7, 2018 | |
| Dianne Brady |
Corporate Director |
Apr 1, 2019 | |
| Kevin L Burns |
Corporate Director |
May 23, 2000 | |
| Elaine Edwards |
Corporate Director |
Apr 1, 2019 | |
| Patrick J Peters |
Contracted Managing Employee |
Feb 6, 2023 | |
| Corporate Director |
Feb 6, 2023 | ||
| William Schwenker |
Corporate Director |
Jul 1, 2019 | |
| Debra K Renner |
Corporate Director |
Jan 1, 2023 | |
| Mercy Health Network Inc |
Operational/Managerial Control | Sep 1, 2023 | 100% |
| James Thines |
Corporate Director |
Oct 1, 2019 | |
| Matthew Osterhaus |
Corporate Director |
Jul 1, 2016 | |
| Kolin Huth |
Corporate Director |
Mar 15, 2023 | |
| W-2 Managing Employee |
Mar 15, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061104000661 | IA | Part a Provider - Critical Access Hospital | 1254248958 |
Receives reassigned benefits from 64 practitioners Practice locations: Maquoketa, IA |
National Provider Directory
- Tax ID family
- Jackson County Public H
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 490099H | IA | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0600569 | Medicaid | IA |
Other names
- JACKSON COUNTY REGIONAL HEALTH CENTER
Other providers in Maquoketa, IA
- Jackson County Public Hospital
- Jackson County Public Hospital
- Jackson County Public Hospital
- Jackson County Public Hospital
- Jackson County Public Hospital
- Jackson Ia Opco LLC
- Jay Allen Jackson
- Gloria Jorgensen
- Adrienne D'Agostino Kane
- Paul Henry Koob
All providers in Maquoketa, IA · Critical Access Hospital in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.