NPIMap

Organization Active NPI

Greene County Medical Center

Doing business as Panora Medical Clinic

  • Rural Health Clinic/Center
  • Panora, IA
National Provider Identifier
1962436972
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GREENE COUNTY MEDICAL CENTER
Doing business as
Panora Medical Clinic
Practice address
803 E Main St
Panora, IA 50216-1055
Phone
(641) 755-2121
Fax
(641) 755-2314
NPI assigned
Jul 10, 2006
Last updated
Jun 8, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
GREENE COUNTY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Authorized official

Name
Mr. Mark A Vanderlinden
Title
Cfo
Phone
(515) 386-2114

Specialties & licenses 1

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

Addresses

Primary practice location

803 E Main St
Panora, IA 50216-1055

Mailing address

803 E Main St
Panora, IA 50216-1055
Phone (641) 755-2121

Other identifiers 1

IdentifierTypeStateIssuer
0634816MedicaidIA

Other names 1

  • Panora Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040712000717 IA Part B Supplier - Clinic/Group Practice 0143208595 Receives reassigned benefits from 30 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jefferson, IA

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory
Part of
Medical Imaging PC

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1962436972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 E MAIN ST",
            "city": "PANORA",
            "state": "IA",
            "postal_code": "502161055",
            "telephone_number": "641-755-2121",
            "fax_number": "641-755-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 E MAIN ST",
            "city": "PANORA",
            "state": "IA",
            "postal_code": "502161055",
            "telephone_number": "641-755-2121",
            "fax_number": "641-755-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE COUNTY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREENE COUNTY MEDICAL CENTER",
        "enumeration_date": "2006-07-10",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "VANDERLINDEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "515-386-2114",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0634816",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Panora Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Panora, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.