NPIMap

Organization Active NPI

St. Luke's Jones Regional Medical Center

Doing business as Jones Regional Medical Center Physician Services

  • Emergency Medicine Physician
  • Anamosa, IA
National Provider Identifier
1942397328
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ST. LUKE'S JONES REGIONAL MEDICAL CENTER
Doing business as
Jones Regional Medical Center Physician Services
Practice address
1795 Highway 64 E
Anamosa, IA 52205-2112
Phone
(319) 462-6131
Fax
(319) 462-4689
NPI assigned
Oct 6, 2006
Last updated
Mar 9, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. LUKE'S JONES REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Authorized official

Name
Mr. Eric Briesemeister
Title
Ceo
Phone
(319) 462-6131

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Anesthesiologist Assistant 367H00000X
Registered Nurse 163W00000X
Emergency Medicine Physician 207P00000X Primary
Family Medicine Physician 207Q00000X
Physical Therapist 225100000X
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X
Other Specialist/Technologist 246Z00000X

Addresses

Primary practice location

1795 Highway 64 E
Anamosa, IA 52205-2112

Mailing address

1795 Highway 64 E
Anamosa, IA 52205-2112
Phone (319) 462-6131

Other identifiers 1

IdentifierTypeStateIssuer
4319OtherIABLUE CROSS

Other names 1

  • Jones Regional Medical Center Physician Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031226000198 IA Part B Supplier - Clinic/Group Practice 4688572811 Receives reassigned benefits from 110 practitioners
2 other NPIs on this enrollment
Practice locations: Anamosa, IA

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Part of
Jones Regional Emergenc

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Jones Regional Medical CenterAnamosa, IA, CCN 16Z306 Hospital 5% Or Greater Direct Ownership Interest (5%)
Operational/Managerial Control		 Oct 1, 2007
Oct 3, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 115

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 115

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489017600000",
    "number": "1942397328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 HIGHWAY 64 E",
            "city": "ANAMOSA",
            "state": "IA",
            "postal_code": "522052112",
            "telephone_number": "319-462-6131",
            "fax_number": "319-462-4689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 HIGHWAY 64 E",
            "city": "ANAMOSA",
            "state": "IA",
            "postal_code": "522052112",
            "telephone_number": "319-462-6131",
            "fax_number": "319-462-4689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S JONES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. LUKE'S JONES REGIONAL MEDICAL CENTER",
        "enumeration_date": "2006-10-06",
        "last_updated": "2017-03-09",
        "status": "A",
        "authorized_official_last_name": "BRIESEMEISTER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-462-6131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4319",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jones Regional Medical Center Physician Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anamosa, IA

Sources for this page

Verify at the official NPI Registry.