NPIMap

Organization Active NPI

Mahaska County Hospital

  • Community Based Hospice Care Agency
  • Oskaloosa, IA
National Provider Identifier
1003886110
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
MAHASKA COUNTY HOSPITAL
Practice address
630 N 12TH St
Oskaloosa, IA 52577-2466
Phone
(641) 672-3470
Fax
(641) 672-3336
NPI assigned
Jan 23, 2006
Organization subpart
Yes
Parent organization
MAHASKA COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kevin Deronde
Title
Ceo
Phone
(641) 672-3100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary
Inpatient Hospice 315D00000X

Addresses

Primary practice location

630 N 12TH St
Oskaloosa, IA 52577-2466

Mailing address

1229 C Ave E
Oskaloosa, IA 52577-4298
Phone (641) 672-3236

Other names 1

  • MAHASKA HEALTH HOSPICE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070608000241 IA Part A Provider - Hospice 2769388677 Practice locations: Oskaloosa, IA

Hospice certification: CCN 161511

Legal name
MAHASKA COUNTY HOSPITAL
Doing business as
MAHASKA HEALTH HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 22, 1989
Last certification
Oct 20, 2018
Ownership / control type
Government - State
Organization structure
OtherNon-profit
Enrollment address
630 N 12TH St
Oskaloosa, IA 52577-2466

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Mahaska Health Partnership Hospice ServicesCCN 161511
Ownership
Government
Certified
Mar 22, 1989
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Gary F Marklin MD14 organizations share this tax ID, including this one
Part of
Gary F Marklin MD

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Marsha K Riordan Individual Corporate Officer Nov 17, 2021
Corporate Director Nov 28, 2018
Gregory a Gordy Individual Corporate Officer Sep 22, 2021
Corporate Director Sep 22, 2021
Donna M Arendt Individual Corporate Officer Oct 27, 2021
Corporate Director Oct 27, 2021
Sharon K Dekock Individual W-2 Managing EmployeeHospice Director Jan 3, 2023
Operational/Managerial ControlHospice Director Jan 3, 2023
David M Langkamp Individual Corporate Officer Jan 28, 2013
Corporate Director Nov 28, 2011
Andra King Individual W-2 Managing EmployeeCompliance Director Dec 28, 2020
Operational/Managerial ControlCompliance Director Dec 28, 2020
Guy M Vander Linden Individual Corporate Director Oct 27, 2021
Daris Rosencrance Individual Corporate OfficerCfo Nov 1, 2021
W-2 Managing EmployeeCfo Nov 1, 2021
Operational/Managerial ControlCfo Nov 1, 2021
Joette S Stout Individual Corporate Director Oct 27, 2021
Mark J Zacharjasz Individual W-2 Managing EmployeeMD; Dec 4, 2018
Operational/Managerial ControlHospice Medical Director Dec 4, 2018
Dustin D Hite Individual Corporate Director Apr 26, 2023
Kevin L Deronde Individual Corporate OfficerCeo Feb 19, 2018
W-2 Managing EmployeeCeo Feb 19, 2018
Operational/Managerial ControlCeo Feb 19, 2018
Andrea K Hagist Individual W-2 Managing EmployeeChief Nursing Officer Sep 18, 2017
Operational/Managerial ControlChief Nursing Officer Sep 18, 2017

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oskaloosa Care CenterOskaloosa, IA, CCN 165589 Skilled nursing facility Adp of the SNF May 19, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 128

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 128

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1003886110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 C AVE E",
            "city": "OSKALOOSA",
            "state": "IA",
            "postal_code": "525774298",
            "telephone_number": "641-672-3236",
            "fax_number": "641-372-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N 12TH ST",
            "city": "OSKALOOSA",
            "state": "IA",
            "postal_code": "525772466",
            "telephone_number": "641-672-3470",
            "fax_number": "641-672-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHASKA COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAHASKA COUNTY HOSPITAL",
        "enumeration_date": "2006-01-23",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "DERONDE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-672-3100"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAHASKA HEALTH HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oskaloosa, IA

Sources for this page

Verify at the official NPI Registry.