JEFFERSON COUNTY HOSPITAL (NPI# 1972771384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972771384 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COUNTY HOSPITAL |
| Other Organization Name | JCH PROFESSIONAL CLINIC |
| Practice Address |
2000 S Main St Fairfield IA 52556-9572 |
| Practice Telephone | 6414694204 |
| Practice Fax Number | 6414694208 |
| Mailing Telephone | 6414694204 |
| Mailing Fax Number | 6414694208 |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2020-02-26 |
| Authorized Official Name | LARRY DALE PEACH (CFO) |
| Authorized Official Telephone | 6414694304 |
| Is Organization Subpart | Y |
| Parent Organization Name | JEFFERSON COUNTY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
37410 | IA | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | 22423 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0468850 | 05 | |
| IA | WELLMARK BC/BS OF IA | 33819 | 01 |
| Other Name | Type Code |
|---|---|
| JCH Professional Clinic | Doing Business As Name - Organization |
| 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 |
| 1780894253 | Jefferson County Hospital | Family Medicine | 870 Main Street, Fayette, MS 39069 | 2007-05-23 |
| 1407071913 | Jefferson County Hospital | Personal Emergency Response Attendant | 2000 S Main St, Fairfield, IA 52556-9572 | 2007-04-17 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497982581 | Jennifer S. Schwartz | Surgery | 2000 Post Rd Ste 101, Fairfield, CT 06824-5730 | 2009-06-16 |
| 1992906432 | Alex Vincent Funicello | Surgery | 695 Us Highway 46 Ste 400a, Fairfield, NJ 07004-1568 | 2007-05-31 |
| 1124198742 | Mark Charles Steckel | Surgery | 140 Sherman Street, Fairfield, CT 06824 | 2006-11-09 |
| 1487730719 | Norman Verches Santos | Surgery | 695 Route 46 W, Suite 400a, Fairfield, NJ 07004-1592 | 2006-10-30 |
| 1063459246 | James E Fitzpatrick | Surgery | 3050 Mack Rd Ste 310, Fairfield, OH 45014-5376 | 2006-05-31 |
| 1275581886 | John Peter Zopfi | Surgery | 1860 Pennsylvania Ave., #200, Fairfield, CA 94533 | 2006-05-05 |
| 1982683298 | Beth E Hothanzielinski | Surgery | 2000 S Main, Fairfield, IA 52556-9572 | 2006-01-13 |
| 1104811942 | Robert Alan Lanflisi | Surgery | 1245 Travis Blvd, #f, Fairfield, CA 94533-4898 | 2005-09-19 |
| 1063406874 | Mary F Welsh | Surgery | 695 Us Highway 46, Suite 400a, Fairfield, NJ 07004-1592 | 2005-09-07 |
| 1073506606 | Girish Babu Nagesetty | Surgery | 1251 Nilles Road, Suite17, Fairfield, OH 45014-7205 | 2005-08-30 |
| Find all providers in FAIRFIELD | ||||
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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.