Van Buren County Hospital
Organization Active NPI Rural Health Clinic/Center · Farmington, IA
NPI 1992875678 · NPPES record last updated Mar 5, 2014
Key facts
- NPI
- 1992875678
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- VAN BUREN COUNTY HOSPITAL
- Practice address
- 206 S 4TH St
Farmington, IA 52626-9235 - Phone
- (319) 878-4232
- Fax
- (319) 878-4210
- NPI assigned
- Nov 9, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- VAN BUREN COUNTY HOSPITAL
Authorized official
- Name
- Ms. Kara M. McEntee
- Title
- Cfo
- Phone
- (319) 293-3171
Owners & managing parties with NPI records 2
-
Patricia Lou Tucker, ARNP
-
Dana Renee Brecount, D.O.
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 7
Facilities with the same owner 98
Practitioners 44
-
Elizabeth Diane Dassow, PA-C
-
Augusta R Kincart, PA-C
-
Dianne Kay Knapp, ARNP
-
David Hiram Lane, PA-C
-
Ashleigh Mathews, ARNP
-
Ryan Roe, DO
-
Darren Gregory Stoub, PA-C
-
Kyla Irene Yates, ARNP
-
Dana Renee Brecount, D.O.
-
Kimberly J Farris, PA-C
-
Maria N Gomes, M.D.
-
Mohammad Jarbou, MD
-
Jennifer K Berge, M.D.
-
Jill Ferrell, CRNA
-
Nathalie Francis, MD
-
Cheryl Ann Quinn, D.O.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D0718633 | Farmington Medical Clinic | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Rural health clinic certification: CCN 163452
- Legal name
- VAN BUREN COUNTY HOSPITAL
- Doing business as
- FARMINGTON MEDICAL CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jul 1, 1996
- Last certification
- Apr 14, 2026
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Enrollment address
- 206 S 4TH St
Farmington, IA 52626-9235
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Kara McEntee |
Corporate Officer |
Jul 31, 2013 | |
| W-2 Managing Employee |
Apr 19, 2007 | ||
| Operational/Managerial Control |
Apr 19, 2007 | ||
| Benjamin D Sherod |
Corporate Officer | Jan 28, 2013 | |
| Corporate Director | Oct 22, 2010 | ||
| Patricia Lou Tucker |
Corporate Director | Dec 31, 2022 | |
| Mindy B Cormier |
W-2 Managing Employee |
Sep 6, 2018 | |
| Operational/Managerial Control |
Sep 6, 2018 | ||
| Dana R Brecount |
W-2 Managing Employee |
Jul 1, 2017 | |
| Operational/Managerial Control |
Jul 1, 2017 | ||
| Jeanne Erickson |
Corporate Director | Jan 1, 1997 | |
| Ann McBride |
Corporate Officer | Feb 23, 2021 | |
| Corporate Director | May 26, 2020 | ||
| Garen Carpenter |
Contracted Managing Employee |
Aug 3, 2020 | |
| Corporate Officer |
Aug 3, 2020 | ||
| Operational/Managerial Control |
Aug 3, 2020 | ||
| Quenton Dodson |
Corporate Officer | Feb 27, 2018 | |
| Corporate Director | Mar 29, 2016 | ||
| Mercy Health Network Inc |
Operational/Managerial Control | Mar 1, 2020 | |
| Michael Thomas |
Corporate Director | Jan 1, 1998 | |
| Heather a Charbonneau |
Corporate Officer | Feb 27, 2018 | |
| Corporate Director | Nov 28, 2017 | ||
| Kasha Kite |
W-2 Managing Employee |
Feb 6, 2019 | |
| Operational/Managerial Control |
Feb 6, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100308000432 | IA | Part a Provider - Rural Health Clinic | 7214829530 | Practice locations: Farmington, IA |
National Provider Directory
- Tax ID family
- Van Buren County Hospital
- Part of
- Van Buren County Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
206 S 4TH St
Farmington, IA 52626-9235
Mailing address
304 Franklin St
Keosauqua, IA 52565-1164
Phone (319) 293-3171
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0634527 | Medicaid | IA |
Other names
- Farmington Medical Clinic
Other providers in Farmington, IA
- Rachael Leeann Denly
- Scheuermann Chiropractic PC
- Troy Grant Scheuermann
- Town of Farmington
- Kalyn Tuttle
- Wells Bros. Pharmacy Services, LLC
All providers in Farmington, IA · Rural Health Clinic/Center in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.