MEDICARE: TRINITY REGIONAL MEDICAL CENTER

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	208M00000X	Hospitalist Physician
2	207X00000X	Orthopaedic Surgery Physician
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
4	367500000X	Certified Registered Nurse Anesthetist
5	207P00000X	Emergency Medicine Physician

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1073594156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY REGIONAL MEDICAL CENTER

Provider Business Mailing Address
First Line	:	802 KENYON RD
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-5740
Country	:	US
Telephone Number	:	515-574-6565
Fax Number	:	515-574-6504

Provider Business Practice Location Address
First Line	:	802 KENYON RD
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-5740
Country	:	US
Telephone Number	:	515-573-3101
Fax Number	:	515-573-8710

Authorized Official
Title or Position	:	MARKET PRESIDENT
Name	:	LEAH M GLASGO
Credential	:
Telephone Number	:	515-573-3101

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	03/09/2026

8200 DODGE STREET , CHILDREN'S HOSPITAL & MEDICARE CENTER
OMAHA, NE
68114-4113

Practice Phone: 402-955-6140
Practice Fax: 402-955-3398