JEFFERSON COUNTY HOSPITAL (NPI# 1760581763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760581763 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COUNTY HOSPITAL |
| Practice Address |
2000 S Main St Fairfield IA 52556-9572 |
| Practice Telephone | 6414724111 |
| Practice Fax Number | 6414694375 |
| Mailing Telephone | 6414724111 |
| Mailing Fax Number | 6414694375 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-02-26 |
| Authorized Official Name | LARRY DALE PEACH (CFO) |
| Authorized Official Telephone | 6414694304 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | 510063H | IA | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0655803 | 05 | |
| IA | WELLMARK BC/BS OF IOWA | 66115 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881294536 | Jefferson County Hospital | Clinic/Center | 107 W Harrison St, Richland, IA 52585-9549 | 2020-10-30 |
| 1225247505 | Jefferson County Hospital | Family Medicine | 870 Main Street, Fayette, MS 39069 | 2007-05-22 |
| 1871690289 | Jefferson County Hospital | Nursing Facility/Intermediate Care Facility | 400 Highland St, Fairfield, IA 52556-3713 | 2006-09-20 |
| 1043204555 | Jefferson County Hospital | General Acute Care Hospital | 870 South Main Street, Fayette, MS 39069-0577 | 2005-09-12 |
| 1386018083 | Jefferson County Hospital | Psychiatric Unit | 870 Main St, Fayette, MS 39069-5695 | 2015-11-18 |
| 1457728008 | Jefferson County Hospital | Clinic/Center | 2000b S Main St, Fairfield, IA 52556-9572 | 2015-08-31 |
| 1245643972 | Jefferson County Hospital | Family Medicine | 2000 S Main St, Fairfield, IA 52556-9572 | 2014-06-10 |
| 1487944856 | Jefferson County Hospital | Pharmacy | 2000 S Main St, Fairfield, IA 52556-9572 | 2011-04-19 |
| 1972771384 | Jefferson County Hospital | Internal Medicine | 2000 S Main St, Fairfield, IA 52556-9572 | 2008-02-19 |
| 1780894253 | Jefferson County Hospital | Family Medicine | 870 Main Street, Fayette, MS 39069 | 2007-05-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | JEFFERSON COUNTY HOSPITAL | 870 Main St, Fayette, MS 39069-5695 |
| Street Address |
2000 S MAIN ST |
| City | FAIRFIELD |
| State | IA |
| Zip Code | 52556-9572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205945094 | Michael Leon Pogel | Psychiatry & Neurology | 2000 S Main St, Fairfield, IA 52556-9572 | 2006-08-29 |
| 1528676699 | Dustin C Lane | Pharmacist | 2000 S Main St, Fairfield, IA 52556-9572 | 2020-07-15 |
| 1891318564 | Taylor Madison Buch | Nurse Practitioner | 2000 S Main St, Fairfield, IA 52556-9572 | 2020-05-28 |
| 1164990537 | Rachel N Shaw | Occupational Therapy Assistant | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-11-05 |
| 1982188918 | Suzane Moore | Speech-Language Pathologist | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-09-15 |
| 1558840553 | Eric Dwayne Held | Physical Therapist | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-08-09 |
| 1952889628 | Katherine Page Mccloney | Physical Therapist | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-08-03 |
| 1982106712 | Raelee Lynn Bird | Registered Nurse | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-03-07 |
| 1013416486 | Karly Matlick | Physical Therapist | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-02-12 |
| 1255849626 | Jacob Wilson | Physical Therapist | 2000 S Main St, Fairfield, IA 52556-9572 | 2018-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376175315 | Sarah Jo Chaney | Speech-Language Pathologist | 402 W Burlington Ave, Ste 200, Fairfield, IA 52556 | 2020-02-07 |
| 1588191290 | Kirk D. Condon | Counselor | 201 South 23rd, Fairfield, IA 52556 | 2017-05-12 |
| 1740644483 | Felicity Kelly | Acupuncturist | 206 E Burlington Ave #2, Fairfield, IA 52556 | 2016-04-08 |
| 1275964686 | Donna J Besick | Physical Therapy Assistant | 2000 S. Main St., Fairfield, IA 52556 | 2013-12-11 |
| 1568894731 | Mary Helen Gartin | Family Medicine | 2000c South Main, Fairfield, IA 52556 | 2013-07-30 |
| 1699016287 | Sarah Elizabeth Brooks | Acupuncturist | 1825 Okra Blvd, Fairfield, IA 52556 | 2013-03-07 |
| 1265755631 | Robert H. Schneider | Preventive Medicine | 2100 Mansion Drive, Suite 211 - Inmp, Maharishi Vedic City, IA 52556 | 2010-03-12 |
| 1033346127 | Madison County Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 1401 S Main St Ste 101, Fairfield, IA 52556 | 2009-06-16 |
| 1144490178 | Southeastern Renal Dialysis L.c. | Clinic/Center | 2000 A S Main St, Fairfield, IA 52556 | 2008-03-05 |
| 1497933741 | Rochelle Marie Phelps | Social Worker | 301 W. Burlington, Fairfield, IA 52556 | 2008-02-07 |
| Find all providers in zip 52556 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538373717 | Washington County Hospital | Medicare Defined Swing Bed Unit | 400 East Polk Street, Washington, IA 52353 | 2007-05-09 |
| 1548278328 | Sioux Center Health | Medicare Defined Swing Bed Unit | 1101 9th St. Se, Sioux Center, IA 51250-2501 | 2006-08-04 |
| 1093288292 | Avera Mckennan | Medicare Defined Swing Bed Unit | 1100 S 10th Ave, Rock Rapids, IA 51246-2020 | 2019-01-10 |
| 1649650714 | Mercy Medical Center - Newton | Medicare Defined Swing Bed Unit | 204 N 4th Ave E, Newton, IA 50208-3135 | 2015-06-04 |
| 1922335322 | Story County Hospital | Medicare Defined Swing Bed Unit | 640 S 19th St, Nevada, IA 50201-2902 | 2009-11-06 |
| 1063650034 | Unity Healthcare | Medicare Defined Swing Bed Unit | 1518 Mulberry Ave, Muscatine, IA 52761-3433 | 2009-01-29 |
| 1780892307 | Grinnell Regional Medical Center | Medicare Defined Swing Bed Unit | 210 4th Ave, Grinnell, IA 50112-1898 | 2007-05-18 |
| 1639399827 | Baum Harmon Mercy Hospital | Medicare Defined Swing Bed Unit | 255 N Welch Ave, Primghar, IA 51245-0528 | 2007-04-27 |
| 1447381322 | Veterans Memorial Hospital City of Waukon Ia | Medicare Defined Swing Bed Unit | 40 1st St Se, Waukon, IA 52172-2022 | 2007-03-09 |
| 1356490841 | Ringgold County Hospital | Medicare Defined Swing Bed Unit | 504 N. Cleveland St., Mount Ayr, IA 50854-2201 | 2007-01-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.