MEDICARE: CENTRAL IOWA HOSPITAL CORPORATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	104100000X	Social Worker
3	103K00000X	Behavior Analyst
4	103T00000X	Psychologist
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
6	1041C0700X	Clinical Social Worker
7	163W00000X	Registered Nurse
8	2084P0800X	Psychiatry Physician
9	363A00000X	Physician Assistant
10	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist
11	101YM0800X	Mental Health Counselor

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CG8597	OTHER	IA	RR MEDICARE

General Provider Information

NPI Number	:	1114969086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL IOWA HOSPITAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 843151
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64184-3151
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 UNIVERSITY AVE STE 200
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-8201
Country	:	US
Telephone Number	:	515-241-2300
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MR. PATRICIA ALLEN JR.
Credential	:
Telephone Number	:	515-241-6507

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	12/17/2025

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