Active NPI
Dubuque County Hospital
- Intellectual Disabilities Intermediate Care Facility
- Dubuque, IA
National Provider Identifier
1932039997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- Legal business name
- DUBUQUE COUNTY HOSPITAL
- Practice address
- 2375 Roosevelt St
Dubuque, IA 52001-1479 - Phone
- (563) 583-1781
- NPI assigned
- May 21, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Danielle Ettema
- Title
- Administrator
- Phone
- (563) 583-1781
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | Primary |
Addresses
Primary practice location
2375 Roosevelt St
Dubuque, IA 52001-1479
Mailing address
2375 Roosevelt St
Dubuque, IA 52001-1479
Other names 1
- Sunnycrest Manor ICF/IID
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Intermediate care facility for individuals with intellectual disabilities certification: CCN 16G008
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- SUNNYCREST MANOR
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Jan 1, 1980
- Last certification
- Dec 5, 2024
- Beds
- 28
- Ownership / control type
- County
- Facility address
- 2375 Roosevelt Street
Dubuque, IA 52001
National Provider Directory
National Provider Directory- Tax ID family
- Dubuque County Hospital
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Dubuque, IA
- NPI 1104756121
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779321600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1779321600000",
"number": "1932039997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2375 ROOSEVELT ST",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520011479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2375 ROOSEVELT ST",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520011479",
"telephone_number": "563-583-1781"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DUBUQUE COUNTY HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2026-05-21",
"last_updated": "2026-05-21",
"certification_date": "2026-05-21",
"status": "A",
"authorized_official_last_name": "ETTEMA",
"authorized_official_first_name": "DANIELLE",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "563-583-1781"
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sunnycrest Manor ICF/IID",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Dubuque, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.