NPIMap

Organization Active NPI

Delaware County Memorial Hospital

Doing business as Backbone Area Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manchester, IA
National Provider Identifier
1982667929
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
DELAWARE COUNTY MEMORIAL HOSPITAL
Doing business as
Backbone Area Counseling Center
Practice address
709 W Main St
Manchester, IA 52057-1526
Phone
(563) 927-7330
Fax
(563) 927-7409
NPI assigned
Apr 10, 2006
Last updated
Jan 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Authorized official

Name
Mr. Lon Butikofer, RN, PHD
Title
Ceo
Phone
(563) 927-3232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

709 W Main St
Manchester, IA 52057-1526

Mailing address

709 W Main St
Manchester, IA 52057-1526
Phone (563) 927-7330

Other names 1

  • Backbone Area Counseling Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000881 IA Part B Supplier - Clinic/Group Practice 2062316375 Receives reassigned benefits from 178 practitioners
2 other NPIs on this enrollment
Practice locations: Dyersville, IA; Winthrop, IA; Manchester, IA; Strawberry PT, 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

Locations

2300 Swan Lake Blvd
Ste 203
Independence, IA 50644
Phone (319) 334-5155

120 E Charles St
Oelwein, IA 50662

Ownership & related parties

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Regional Medical CenterManchester, IA, CCN 161343 Hospital Operational/Managerial Control Aug 28, 2013
Regional Medical CenterManchester, IA, CCN 16Z343 Hospital Operational/Managerial Control Aug 28, 2013
Regional Family Health EdgewoodEdgewood, IA, CCN 168531 Rural health clinic Operational/Managerial Control Jan 1, 1966
Regional Family Health HopkintonHopkinton, IA, CCN 168529 Rural health clinic Operational/Managerial Control Apr 1, 2009
Regional Family Health ManchesterManchester, IA, CCN 168530 Rural health clinic Operational/Managerial Control (100%) Apr 1, 2009
Regional Family Health Strawberry PointStrawberry Point, IA, CCN 168528 Rural health clinic Operational/Managerial Control Apr 1, 2009
Regional Family Health WinthropWinthrop, IA, CCN 168554 Rural health clinic Operational/Managerial Control (100%) Aug 1, 1966

Owned or controlled facilities with NPI records 8

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

Practitioners & affiliated clinicians

Practitioners 185

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 185

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1982667929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571526",
            "telephone_number": "563-927-7330",
            "fax_number": "563-927-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571526",
            "telephone_number": "563-927-7330",
            "fax_number": "563-927-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "BUTIKOFER",
        "authorized_official_first_name": "LON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-927-3232",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN, PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Backbone Area Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, IA

Sources for this page

Verify at the official NPI Registry.