Active NPI
Wesley Community Services, Inc.
- Adult Care Home Facility
- Des Moines, IA
National Provider Identifier
1114088168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- Legal business name
- WESLEY COMMUNITY SERVICES, INC.
- Practice address
- 3206 University Ave
Des Moines, IA 50311-3820 - Phone
- (515) 288-3334
- NPI assigned
- Dec 13, 2006
- Last updated
- Jan 12, 2024
- Organization subpart
- Yes
- Parent organization
- WESLEYLIFE
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Krysta Stevens
- Title
- Accountant
- Phone
- (515) 699-3367
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | |||
| Adult Care Home Facility | 311ZA0620X | Primary | ||
| Home Delivered Meals | 332U00000X |
Addresses
Primary practice location
3206 University Ave
Des Moines, IA 50311-3820
Mailing address
944 18TH St
Des Moines, IA 50314-1152
Phone (515) 288-3334
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0714170 | Medicaid | IA | |
| 0481952 | Medicaid | IA | |
| 0105692 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071119000714 | IA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8729002506 | Practice locations: Urbandale, IA |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Wesley Community Hospice
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Urbandale, IA
- NPI 1154146330
8729002506
-
dba WesleyLife Hospice
- Community Based Hospice Care Agency
- Johnston, IA
- NPI 1730380361
8729002506
National Provider Directory
National Provider Directory- Tax ID family
- Wesley Community Services
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Wesley Community Hospice
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Urbandale, IA
- NPI 1154146330
-
dba WesleyLife Hospice
- Community Based Hospice Care Agency
- Johnston, IA
- NPI 1730380361
Ownership & related parties
All facility ownership & control disclosures 2
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Wesleylife Home Health | Home health agency | Operational/Managerial Control (40%) | Sep 1, 2007 |
| Wesleylife Hospice | Hospice | 5% Or Greater Direct Ownership Interest Operational/Managerial Control (40%) |
Jan 1, 2006 Sep 1, 2007 |
Owned or controlled facilities with NPI records 2
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba WesleyLife Hospice
- Community Based Hospice Care Agency
- Johnston, IA
- NPI 1730380361
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1705017600000",
"number": "1114088168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "944 18TH ST",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503141152",
"telephone_number": "515-288-3334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3206 UNIVERSITY AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503113820",
"telephone_number": "515-288-3334"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WESLEY COMMUNITY SERVICES, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WESLEYLIFE",
"enumeration_date": "2006-12-13",
"last_updated": "2024-01-12",
"certification_date": "2024-01-12",
"status": "A",
"authorized_official_last_name": "STEVENS",
"authorized_official_first_name": "KRYSTA",
"authorized_official_title_or_position": "ACCOUNTANT",
"authorized_official_telephone_number": "515-699-3367"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": null,
"license": null,
"primary": true
},
{
"code": "332U00000X",
"taxonomy_group": "",
"desc": "Home Delivered Meals",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0714170",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0481952",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0105692",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.