NPIMap

Organization Active NPI

Adair County Memorial Hospital

Doing business as Adair County Medical Clinic Stuart

  • Rural Health Clinic/Center
  • Stuart, IA
National Provider Identifier
1932440146
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ADAIR COUNTY MEMORIAL HOSPITAL
Doing business as
Adair County Medical Clinic Stuart
Practice address
303 SW 7TH St
Suite B
Stuart, IA 50250-2164
Phone
(515) 523-2513
NPI assigned
Mar 13, 2013
Last updated
Feb 20, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ADAIR COUNTY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Authorized official

Name
Catherine Hillestad
Title
Ceo
Phone
(641) 743-2123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X IA Primary

Addresses

Primary practice location

303 SW 7TH St
Suite B
Stuart, IA 50250-2164

Mailing address

609 SE Kent St
Greenfield, IA 50849-9494
Phone (641) 743-2123

Other names 1

  • Adair County Medical Clinic Stuart Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130919000032 IA Part A Provider - Rural Health Clinic 3072403153 Practice locations: Stuart, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932440146. Details of each certification follow.

Rural health clinic certification: CCN 168576

Legal name
ADAIR COUNTY MEMORIAL HOSPITAL
Doing business as
ADAIR COUNTY MEDICAL CLINIC STUART
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 15, 2016
Last certification
Feb 11, 2021
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
303 SW 7TH St
Ste B
Stuart, IA 50250-2164
Related CCNs
161310

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

Other NPIs with the same Medicare PAC ID 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0888178Adair County Medical Clinic-Stuart303 SW 7TH Street Suite B, Stuart, IA 50250Certificate of waiverNov 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Adair County Mem Hosp6 organizations share this tax ID, including this one
Part of
Adair County Mem Hosp

Other organizations with this tax ID 5

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

Locations

303 SW 7th St
Ste B
Stuart, IA 50250
Phone (515) 523-2513

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
Matthew R Haley Individual Corporate OfficerCfo Aug 1, 2022
W-2 Managing EmployeeCfo Aug 1, 2022
Operational/Managerial ControlCfo Aug 1, 2022
Mark a Schildberg Individual Corporate Director Jan 1, 2023
Mercy Health Network Inc Organization, Clive, IA Corporation, Management services company, Non-profit Operational/Managerial Control Nov 1, 2012
Willard Olesen Individual Corporate Officer Jan 1, 2024
Corporate Director Jan 1, 2009
Barbara G Kalbach Individual Corporate Officer Jan 24, 2023
Corporate Director Mar 1, 2017
Bo Geidel Individual Corporate Director Jan 1, 2024
Debra J Tindle Individual Corporate Director Jan 1, 2021
Catherine Hillestad Individual Contracted Managing EmployeeCeo Jul 7, 2021
Corporate OfficerCeo Jul 7, 2021
Operational/Managerial ControlCeo Jul 7, 2021
James G Freeland Individual Corporate Officer Jan 24, 2023
Corporate Director Jan 1, 2021
Timothy C Piearson Individual Contracted Managing EmployeeMD; Jun 6, 2023
Operational/Managerial ControlMedical Director Jun 6, 2023
Lee L Fry Individual W-2 Managing EmployeeClinic Manager Sep 20, 2016
Operational/Managerial ControlClinic Manager Sep 20, 2016

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1932440146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 SE KENT ST",
            "city": "GREENFIELD",
            "state": "IA",
            "postal_code": "508499494",
            "telephone_number": "641-743-2123",
            "fax_number": "641-743-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 SW 7TH ST",
            "address_2": "SUITE B",
            "city": "STUART",
            "state": "IA",
            "postal_code": "502502164",
            "telephone_number": "515-523-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADAIR COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADAIR COUNTY MEMORIAL HOSPITAL",
        "enumeration_date": "2013-03-13",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "HILLESTAD",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-743-2123"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adair County Medical Clinic Stuart",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adair County Medical Clinic Stuart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stuart, IA

Sources for this page

Verify at the official NPI Registry.