NPIMap

Organization Active NPI

Sioux Valley Memorial Hospital Association

  • Community Based Hospice Care Agency
  • Cherokee, IA
National Provider Identifier
1215976709
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SIOUX VALLEY MEMORIAL HOSPITAL ASSOCIATION
Practice address
1000 S 2ND St
Cherokee, IA 51012-2173
Phone
(712) 225-6459
Fax
(712) 225-1096
NPI assigned
Jun 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

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

Authorized official

Name
Joan M Bierman
Title
Cfo
Phone
(712) 225-1505

Specialties & licenses 1

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

Addresses

Primary practice location

1000 S 2ND St
Cherokee, IA 51012-2173

Mailing address

300 Sioux Valley Dr
Cherokee, IA 51012-1205
Phone (712) 225-5101

Other names 1

  • Cherokee Regional Medical Center Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030515000055 IA Part A Provider - Hospice 4880501881 Practice locations: Cherokee, IA

Hospice certification: CCN 161537

Legal name
SIOUX VALLEY MEMORIAL HOSPITAL ASSOCIATION
Doing business as
CHEROKEE REGIONAL HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 1, 1994
Last certification
Jul 15, 2021
Ownership / control type
Non-Profit - Private
Organization structure
OtherNon-profit
Enrollment address
212 E Bow Dr
Cherokee, IA 51012-1215

Other NPIs with the same Medicare PAC ID 9

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Cherokee Regional HospiceCCN 161537
Ownership
Non-Profit
Certified
Nov 1, 1994
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Gene E Michel MD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Tyler Gerstandt Individual Corporate OfficerCfo Apr 7, 2023
Kellen Ludvigson Individual Corporate Director Apr 12, 2021
Clay Leavitt Individual Corporate Director Apr 13, 2020
St. Luke'S Health System, Inc. Organization, Sioux City, IA Non-profit Operational/Managerial Control Oct 1, 2013
Wesley a Parker Individual W-2 Managing EmployeeMedical Director Jun 20, 1996
Leslie William Todd Individual Corporate Director Apr 13, 2015
Sheila Trapp Individual Corporate Director Apr 9, 2018
Kerry Marie Hurd Individual Corporate Director Apr 12, 2022
Sarah Cook Individual Corporate Director Apr 11, 2016
Gary W Jordan Individual Contracted Managing Employee Mar 18, 2019
Brandon Henke Individual Corporate Director Apr 12, 2021
Tonya Oolman Individual W-2 Managing Employee Jan 31, 2021

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
Heartland Care Center IncMarcus, IA, CCN 165397 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Jul 19, 2023
Jul 19, 2023
Jul 19, 2023

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 11

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 10

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": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444348800000",
    "number": "1215976709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SIOUX VALLEY DR",
            "city": "CHEROKEE",
            "state": "IA",
            "postal_code": "510121205",
            "telephone_number": "712-225-5101",
            "fax_number": "712-225-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S 2ND ST",
            "city": "CHEROKEE",
            "state": "IA",
            "postal_code": "510122173",
            "telephone_number": "712-225-6459",
            "fax_number": "712-225-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIOUX VALLEY MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2015-10-09",
        "status": "A",
        "authorized_official_last_name": "BIERMAN",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "712-225-1505"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cherokee Regional Medical Center Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cherokee, IA

Sources for this page

Verify at the official NPI Registry.