Hamilton County Public Hospital
Organization Active NPI Rural Health Clinic/Center · Webster City, IA
NPI 1174968697 · NPPES record last updated Apr 9, 2021
Key facts
- NPI
- 1174968697
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- HAMILTON COUNTY PUBLIC HOSPITAL
- Practice address
- 2350 Hospital Dr Ste a
Webster City, IA 50595-6600 - Phone
- (515) 832-7800
- Fax
- (515) 832-9498
- NPI assigned
- May 10, 2013
- Organization subpart
- Yes
- Parent organization (as reported)
- HAMILTON COUNTY PUBLIC HOSPITAL
Authorized official
- Name
- Alice Heinrichs
- Title
- Cfo
- Phone
- (515) 832-9400
Owners & managing parties with NPI records 2
-
Subhash C Sahai, M.D.
-
Kyle M Heffernan, DC
Other NPIs on the same Medicare enrollment 7
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 12
Related certifications (CCN) 2
Facilities with the same owner 98
Practitioners 39
-
John Birkett, MD
-
Nicole L. Ehn, M.D.
-
Robert H Hoyt, M.D.
-
Alan P Nguyen, DO
-
Subhash C Sahai, M.D.
-
Benjamin J. Willis, D.P.M.
-
Giselle Marie Allred, ARNP
-
Lee Carlson, ARNP-C
-
Darin Eklund, P.A.-C.
-
Christopher Ryan Foster, AGACNP-BC, ARNP
-
Jeffrey Hadwiger, ARNP
-
Bart P Jenson, M.D.
-
Amanda Langford, ARNP
-
Mary Claire Lopez, ARNP
-
Tonia Odden, PA-C
-
Rakshak Sarda, MD
-
Roshan Sinha, MD
-
Samantha R. Snovelle, LMHC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D2062767 | Van Diest Family Health Clinic | Certificate of waiver | Jul 21, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA
Rural health clinic certification: CCN 168589
- Legal name
- HAMILTON COUNTY PUBLIC HOSPITAL
- Doing business as
- VAN DIEST FAMILY HEALTH CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Sep 13, 2017
- Last certification
- Sep 13, 2017
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Enrollment address
- 2350 Hospital Dr
Ste a
Webster City, IA 50595-6600 - Related CCNs
- 161361
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Kyle Martin Heffernan |
Corporate Officer |
Jan 28, 2020 | |
| Amy McDonough |
Corporate Officer |
Jan 3, 2018 | |
| W-2 Managing Employee |
Jan 3, 2018 | ||
| Operational/Managerial Control |
Jan 3, 2018 | ||
| David Everson |
Corporate Director | May 26, 2020 | |
| Subhash Sahai |
W-2 Managing Employee |
Oct 1, 2016 | |
| Operational/Managerial Control |
Oct 1, 2016 | ||
| Darcy Swon |
Corporate Director | Jul 28, 2015 | |
| Ashley N Allers |
Corporate Officer |
Apr 1, 2022 | |
| W-2 Managing Employee |
Jan 16, 2012 | ||
| Operational/Managerial Control |
Apr 1, 2022 | ||
| Kirk McCollough |
Corporate Officer | Jan 1, 2017 | |
| Corporate Director | Jan 20, 2015 | ||
| Mercy Health Network Inc |
Operational/Managerial Control | Jul 1, 2010 | |
| Leigh Miller |
W-2 Managing Employee |
Sep 27, 2017 | |
| Operational/Managerial Control |
Sep 27, 2017 | ||
| Carroll D Ose |
Corporate Officer | Jan 1, 2017 | |
| Corporate Director | Jan 2, 2013 | ||
| Lisa Ridge |
Contracted Managing Employee |
Oct 1, 2017 | |
| Corporate Officer |
Oct 1, 2017 | ||
| Operational/Managerial Control |
Oct 1, 2017 | ||
| Michelle Zahn |
Corporate Director |
Aug 23, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031216000775 | IA | Part B Supplier - Clinic/Group Practice | 1254241565 |
Receives reassigned benefits from 78 practitioners 7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Webster City, IA; Stratford, IA; Jewell, IA; Fort Dodge, IA |
| O20170615001719 | IA | Part a Provider - Rural Health Clinic | 1254241565 | Practice locations: Webster City, IA |
National Provider Directory
- Tax ID family
- Hamilton County Public Hospital
- Part of
- Hamilton County Public Hospital
Locations
2419 2nd Ave N
Fort Dodge, IA 50501
Phone (515) 576-2235
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife |
176B00000X | |||
| Family Medicine Physician |
207Q00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
2350 Hospital Dr Ste a
Webster City, IA 50595-6600
Mailing address
PO Box 430
Webster City, IA 50595-0430
Phone (515) 832-9400
Other names
- Van Diest Family Health Clinic
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | himadmin@vdmc.cernerdirect.com | Direct |
Other providers in Webster City, IA
- Hamilton County Public Hospital
- Hamilton County Public Hospital
- Hamilton County Public Hospital
- Hamilton County Public Hospital
- Hamilton County Public Hospital
- Hamilton County Public Hospital
- Hamilton County Public Hospital
- Hamilton County Public Hospital Home Care
- Hamilton County Social Services
- Hamilton County Social Services
All providers in Webster City, IA · Rural Health Clinic/Center in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2021. 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.