NPI Record of POCAHONTAS COMMUNITY HOSPITAL HOSPICE (POCAHONTAS COMMUNITY HOSPITAL) NPI 1922116607

Hospice Care, Community Based in Pocahontas, IA

Complete NPI Record

Field Name Value Definition
NPI1922116607The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business NamePOCAHONTAS COMMUNITY HOSPITALThe name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization NamePOCAHONTAS COMMUNITY HOSPITAL HOSPICEOther name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address606 NW 7TH STThe first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City NamePOCAHONTASThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameIAThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code505741099The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number7123353501The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number7123354116The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address606 NW 7TH STThe first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePOCAHONTASThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameIAThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code505741099The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number7123353430The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number7123354116The fax number associated with the location address of the provider being identified.
Provider Enumeration Date8/25/2006The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date9/21/2012The date that a record was last updated or changed.
Authorized Official Last NameROETMANThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameJAMESThe first name of the authorized official.
Authorized Official Middle NameD.The middle name of the authorized official.
Authorized Official Title or PositionCEOThe title or position of the authorized official.
Authorized Official Telephone Number7123353501The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1251G00000XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1Y
Other Provider Identifier 161522Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 101Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1IA
Other Provider Identifier Issuer 1BLUE CROSS HOSPICE
Other Provider Identifier 20615229Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 205Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2IA
Is Organization SubpartY
Parent Organization LBNPOCAHONTAS COMMUNITY HOSPITAL
Parent Organization TINUNAVAIL
Authorized Official Name Prefix TextMR.