Knoxville Community Hospital Inc
Organization Active NPI Critical Access Hospital · Knoxville, IA
NPI 1922087915 · NPPES record last updated Oct 26, 2011
Key facts
- NPI
- 1922087915
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- 630031H (IA)
- Legal business name
- KNOXVILLE COMMUNITY HOSPITAL INC
- Practice address
- 1002 South Lincoln St
Knoxville, IA 50138-3155 - Phone
- (641) 842-2151
- Fax
- (641) 842-1470
- NPI assigned
- Jan 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Kevin L. Kincaid
- Title
- Ceo
- Phone
- (641) 842-1400
Owners & managing parties with NPI records 2
-
Lori L Bailey, ARNP
-
Samantha Keady, D.O.
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 7
Related certifications (CCN) 1
Facilities with the same owner 98
Practitioners 110
-
Betsy Jo Bolton, PA-C
-
Brandi L Booth, A.R.N.P.
-
Heather Jo Cadwell, CRNA
-
Gabriel Conley, MD
-
Laci Ann Dykstra, ARNP
-
Mark Douglas Fish, D.O.
-
Thomas Brent Hoehns, M.D.
-
Samantha Keady, D.O.
-
Ryan Edward Laughlin, D.O.
-
James Benjamin Law, D.O.
-
Michael S Lee, DPM
-
Dylan J Lowe, D.O.
-
Timothy C McCoy, DO
-
Todd Charles Peterson, D.O.
-
Jared L Rietveld, DO
-
Kate Marie Ripperger, ARNP
Affiliated clinicians 146
-
Nandita Agarwal, M.D.
-
Ravinder Kumar Agarwal, M.D.
-
Steven A. Aviles, MD
-
Angela Durham Beckel, ARNP
-
Adam M. Bell, M.D.
-
Kelsey Nicole Bieghler, ARNP
-
Mark S Bissing, D.O.
-
Mitchell Lee Blom, D.O.
-
Betsy Jo Bolton, PA-C
-
Brandi L Booth, A.R.N.P.
-
Samantha Breakbill, ARNP
-
Kara Anne Buckingham, PA-C
-
Sara Burg, ARNP
-
Ryan William Buss, M.D.
-
Julianne N/a Carson-Hem, ARNP
-
David Kum-Wah Chew, M.D.
-
Melisa Coaker, MD
-
Marsha Collins, PA-C
-
Gabriel Conley, MD
-
Robert D Conner, DO
-
Marcy Michelle Covert, FNP-C
-
Shelby Dames, M.D.
Medicare Care Compare: Hospital
- Listed as
- Knoxville Hospital & Clinics
- Overall star rating
- ★★☆☆☆ 2 of 5
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Hospital certification: CCN 161355
- Legal name
- KNOXVILLE COMMUNITY HOSPITAL INC
- Doing business as
- KNOXVILLE HOSPITAL & CLINICS
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Dec 1, 2003
- Last certification
- Mar 30, 2023
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 1002 S Lincoln St
Knoxville, IA 50138-3155
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Cindi Fuller |
Corporate Officer | Sep 1, 2018 | |
| Corporate Director | Sep 1, 2018 | ||
| Lori L Bailey |
Corporate Director | Jan 1, 2016 | |
| Samantha D Keady |
W-2 Managing Employee |
Jan 1, 2022 | |
| Sally Clark |
W-2 Managing Employee |
Aug 22, 1988 | |
| Operational/Managerial Control |
Aug 22, 1988 | ||
| Mercy Health Network Inc |
Operational/Managerial Control | Nov 1, 2012 | |
| David a Johnson |
Corporate Director | Jan 1, 2014 | |
| James K Butler |
Corporate Officer | Jan 1, 2017 | |
| Corporate Director | Jan 1, 2014 | ||
| Michelle a Greene |
Corporate Director | Apr 28, 2025 | |
| Anthony J Aylsworth |
Corporate Director | Apr 28, 2025 | |
| Lisa Crossett |
Corporate Director | Jan 1, 2014 | |
| Kevin L Kincaid |
Contracted Managing Employee |
Aug 23, 2011 | |
| Corporate Officer |
Oct 28, 2013 | ||
| Operational/Managerial Control |
Aug 23, 2011 | ||
| Todd Chambers |
Corporate Officer | Jan 1, 2021 | |
| Corporate Director | Jan 1, 2016 | ||
| Sean Dhabalt |
Corporate Officer |
May 19, 2025 | |
| W-2 Managing Employee |
May 19, 2025 | ||
| Operational/Managerial Control |
May 19, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061104000267 | IA | Part a Provider - Critical Access Hospital | 6608787056 |
Receives reassigned benefits from 108 practitioners 1 other NPI on this enrollment Practice locations: Pleasantville, IA; Knoxville, IA |
National Provider Directory
- Tax ID family
- Pleasantville Clinic
Locations
1002 S Lincoln St
Knoxville, IA 50138
Phone (641) 842-1464
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 630031H | IA | Yes |
Addresses
Primary practice location
1002 South Lincoln St
Knoxville, IA 50138-3155
Mailing address
1002 South Lincoln St
Knoxville, IA 50138-3155
Phone (641) 842-2151
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0601146 | Medicaid | IA | |
| 60114 | Other | IA | WELLMARK BLUE CROSS IA |
Other names
- Knoxville Hospital & Clinics
Other providers in Knoxville, IA
- Knoxville Area Community Hospital
- Knoxville Care Partners LLC
- Knoxville Chiropractic Clinic PC
- Knoxville Community Hospital Inc
- Knoxville Community Hospital Inc
- Knoxville Community Hospital Inc
- Knoxville Community Hospital Inc.
- Knoxville Community School District
- Knoxville Dental Center, P.C.
- Knoxville Hospital and Clinics
All providers in Knoxville, 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 Oct 26, 2011. 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.