NPIMap

Organization Active NPI

Knoxville Community Hospital Inc

Doing business as Knoxville Hospital & Clinics

  • Critical Access Hospital
  • Knoxville, IA
National Provider Identifier
1922087915
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
630031H Issued in IA
Legal business name
KNOXVILLE COMMUNITY HOSPITAL INC
Doing business as
Knoxville Hospital & Clinics
Practice address
1002 South Lincoln St
Knoxville, IA 50138-3155
Phone
(641) 842-2151
Fax
(641) 842-1470
NPI assigned
Jan 10, 2006
Last updated
Oct 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Authorized official

Name
Mr. Kevin L. Kincaid
Title
Ceo
Phone
(641) 842-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 630031H IA Primary

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 names 1

  • Knoxville Hospital & Clinics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922087915. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
1002 S Lincoln St
Knoxville, IA 50138-3155

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).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Knoxville Hospital & ClinicsCCN 161355 · All quality measures
Overall star rating
2 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Knoxville Comm Hospital8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

16305 Sand Canyon Ave
Ste 260
Irvine, CA 92618
Phone (949) 360-0300

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Cindi Fuller Individual Corporate Officer Sep 1, 2018
Corporate Director Sep 1, 2018
Lori L Bailey Individual Corporate Director Jan 1, 2016
Samantha D Keady Individual W-2 Managing EmployeeMedical Staff President Jan 1, 2022
Sally Clark Individual W-2 Managing EmployeeInsurance Clerk Aug 22, 1988
Operational/Managerial ControlInsurance Clerk Aug 22, 1988
Mercy Health Network Inc Organization, Clive, IA Corporation, Management services company, Non-profit Operational/Managerial Control Nov 1, 2012
David a Johnson Individual Corporate Director Jan 1, 2014
James K Butler Individual Corporate Officer Jan 1, 2017
Corporate Director Jan 1, 2014
Michelle a Greene Individual Corporate Director Apr 28, 2025
Anthony J Aylsworth Individual Corporate Director Apr 28, 2025
Lisa Crossett Individual Corporate Director Jan 1, 2014
Kevin L Kincaid Individual Contracted Managing EmployeeCeo Aug 23, 2011
Corporate OfficerCeo Oct 28, 2013
Operational/Managerial ControlCeo Aug 23, 2011
Todd Chambers Individual Corporate Officer Jan 1, 2021
Corporate Director Jan 1, 2016
Sean Dhabalt Individual Corporate OfficerCfo May 19, 2025
W-2 Managing EmployeeCfo May 19, 2025
Operational/Managerial ControlCfo May 19, 2025

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 109

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 109

Affiliated clinicians 146

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

View all 146

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1922087915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 SOUTH LINCOLN ST",
            "city": "KNOXVILLE",
            "state": "IA",
            "postal_code": "501383155",
            "telephone_number": "641-842-2151",
            "fax_number": "641-842-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 SOUTH LINCOLN ST",
            "city": "KNOXVILLE",
            "state": "IA",
            "postal_code": "501383155",
            "telephone_number": "641-842-2151",
            "fax_number": "641-842-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOXVILLE COMMUNITY HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-10",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "KINCAID",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-842-1400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IA",
            "license": "630031H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knoxville Hospital & Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Knoxville, IA

Sources for this page

Verify at the official NPI Registry.