Active NPI
Ellsworth Municipal Hospital
- Psychiatric Hospital Unit
- Iowa Falls, IA
National Provider Identifier
1972667731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital Unit
- License
- 420156H
- Legal business name
- ELLSWORTH MUNICIPAL HOSPITAL
- Practice address
- 110 Rocksylvania Ave
Iowa Falls, IA 50126-2431 - Phone
- (641) 648-4631
- Fax
- (641) 648-2850
- NPI assigned
- Dec 19, 2006
- Last updated
- Dec 3, 2020
- Organization subpart
- Yes
- Parent organization
- ELLSWORTH MUNICIPAL HOSPITAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Michael White
- Title
- Cfo
- Phone
- (641) 648-4631
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | 420156H | IA | Primary |
Addresses
Primary practice location
110 Rocksylvania Ave
Iowa Falls, IA 50126-2431
Mailing address
110 Rocksylvania Ave
Iowa Falls, IA 50126-2431
Phone (641) 648-4631
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0600346 | Medicaid | IA | |
| 60034 | Other | IA | BLUE CROSS MH PROVIDER |
Other names 1
- MENTAL HEALTH
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | HIM@elmhn.cernerdirect.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1972667731. Details of each certification follow.
Hospital certification: CCN 160034
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
- ELLSWORTH MUNICIPAL HOSPITAL
- Certification status
- Terminated Other: provider status change, Nov 30, 2005
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Mar 23, 2005
- Beds
- 35
- Ownership / control type
- Local
- Facility address
- 110 Rocksylvania Avenue
Iowa Falls, IA 50126
National Provider Directory
National Provider Directory- Part of
- Lance F Yeoman DO
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1606953600000",
"number": "1972667731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 ROCKSYLVANIA AVE",
"city": "IOWA FALLS",
"state": "IA",
"postal_code": "501262431",
"telephone_number": "641-648-4631",
"fax_number": "641-648-2850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 ROCKSYLVANIA AVE",
"city": "IOWA FALLS",
"state": "IA",
"postal_code": "501262431",
"telephone_number": "641-648-4631",
"fax_number": "641-648-2850"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELLSWORTH MUNICIPAL HOSPITAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ELLSWORTH MUNICIPAL HOSPITAL",
"enumeration_date": "2006-12-19",
"last_updated": "2020-12-03",
"certification_date": "2020-12-03",
"status": "A",
"authorized_official_last_name": "WHITE",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "641-648-4631",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "273R00000X",
"taxonomy_group": "",
"desc": "Psychiatric Unit",
"state": "IA",
"license": "420156H",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0600346",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS MH PROVIDER",
"identifier": "60034",
"state": "IA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "HIM@elmhn.cernerdirect.com",
"affiliation": "N",
"endpointDescription": "Hansen Family Hospital Direct Email Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "920 S Oak St",
"city": "Iowa Falls",
"state": "IA",
"country_code": "US",
"postal_code": "501269506",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "MENTAL HEALTH",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "MENTAL HEALTH",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Iowa Falls, IA
- Ellsworth Municipal Hospital (Hansen Family Hospital Specialty Clinic)
- Ellsworth Municipal Hospital (Ellsworth Family Medicine)
- Ellsworth Municipal Hospital (Ellsworth Family Medicine)
- Ellsworth Municipal Hospital (Hansen Family Hospital)
- Ellsworth Municipal Hospital (Hansen Family Hospital)
- Sharon R Freese, LMSW
- Garner Dialysis LLC (Iowa Falls Mary Greeley Dialysis)
- Craig Gibson, D.O.
- David A. Gimer, DDS
- Pamala K. Hammond, LMSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.