Exira Care Center Corporation
Organization Active NPI Skilled Nursing Facility · Exira, IA
NPI 1174595698 · NPPES record last updated Nov 14, 2018
Key facts
- NPI
- 1174595698
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- N-0106 (IA)
- Legal business name
- EXIRA CARE CENTER CORPORATION
- Practice address
- 409 S Carthage St
Exira, IA 50076-1502 - Phone
- (712) 268-5393
- Fax
- (712) 268-9742
- NPI assigned
- Feb 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Steven Fister
- Title
- Administrator
- Phone
- (712) 268-5393
Owners & managing parties with NPI records 10
-
Stephanie Vampola-Runyan, D.O.
Affiliated clinicians 4
-
Seann M Atkinson, DO
-
Stacey L Bean, PA-C
-
Valerie Ann Riesberg, ARNP
-
Stephanie Vampola-Runyan, D.O.
Medicare Care Compare: Nursing home
- Listed as
- Exira Care Center
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Apr 1, 1999
- Medicare certification status
- Active
- Certified beds
- 60 · 37.7 residents per day on average
- Penalties (3 years)
- 1 · fines totaling $22,880
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D0382718 | Exira Care Center | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Skilled nursing facility certification: CCN 165412
- Legal name
- EXIRA CARE CENTER CORPORATION
- Doing business as
- EXIRA CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1999
- Last certification
- Oct 10, 2024
- Beds
- 60
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 411 S Carthage St
Exira, IA 50076-1502 - Nursing home name
- EXIRA CARE CENTER
All disclosed owners & managing parties 63
| Name | Role | Since | Share |
|---|---|---|---|
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Jan 1, 2023 | |
| Joni Anderson Consulting LLC |
Adp of the SNF | Jun 30, 2018 | |
| Stephanie Lorraine Vampola-Runyan |
Operational/Managerial Control | May 5, 1988 | |
| Adp of the SNF | Sep 15, 2025 | ||
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| Becky a Thompson |
Corporate Director |
May 1, 2025 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Cattail Inc |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| BCG Holdings Inc |
Adp of the SNF | Oct 1, 2024 | |
| Tanya Marshall |
Operational/Managerial Control | May 29, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Iowa Health Care Association |
Adp of the SNF | Oct 1, 2024 | |
| Julie Paulsen |
Operational/Managerial Control | Oct 1, 1994 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Dale Nelson |
Corporate Director |
Oct 1, 2017 | |
| |
Adp of the SNF | Jun 30, 2018 | |
| Marty Burns |
Operational/Managerial Control | Sep 15, 2020 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| Lori Dentlinger |
Operational/Managerial Control | May 25, 2018 | |
| Ecsi Inc |
Adp of the SNF | Oct 1, 2024 | |
| Thomas Godwin |
Corporate Officer |
Oct 1, 2017 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Creative Planning Hold Co LLC |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Aug 1, 2024 | |
| Cattail BCG LLC |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Key Rehabilitation Inc |
Adp of the SNF | Jun 30, 2018 | |
| Tina Olsen |
Operational/Managerial Control | Jan 31, 1994 | |
| Brighton Consulting Group LLC |
Adp of the SNF | Oct 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180912001134 | IA | Part a Provider - Skilled Nursing Facility | 8729338751 | Practice locations: Exira, IA |
National Provider Directory
Locations
411 S Carthage St
Exira, IA 50076
Phone (712) 268-5393
409 S Carthage St
Exira, IA 50076
Phone (712) 268-5393
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | N-0106 | IA | Yes |
Addresses
Primary practice location
409 S Carthage St
Exira, IA 50076-1502
Mailing address
411 S Carthage St
Exira, IA 50076-1502
Phone (712) 268-5393
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174595698 | Medicaid | IA |
Other names
- Exira Care Center
Other providers in Exira, IA
- Audubon County Memorial Hospital
- Audubon County Memorial Hospital
- James D Brokke
- Exira Community School Ditrict
- Exira Family Medicine Clinic, LLC
- Exira Fire & EMS Association Incorporated
- Exira-Ehk Community School District
- Katie L Glade
All providers in Exira, IA · Skilled Nursing Facility in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.