NPIMap

Organization Active NPI

Pella Regional Health Center

Doing business as Hospice of Pella, The Comfort House

  • Community Based Hospice Care Agency
  • Pella, IA
National Provider Identifier
1215979208
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
630165H Issued in IA
Legal business name
PELLA REGIONAL HEALTH CENTER
Doing business as
Hospice of Pella, The Comfort House
Practice address
505 Union St
Pella, IA 50219-1719
Phone
(641) 620-5050
Fax
(641) 620-5080
NPI assigned
Jun 12, 2006
Last updated
Jun 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Authorized official

Name
Robert D. Kroese
Title
Chief Executive Officer
Phone
(641) 628-6604

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 630165H IA Primary

Addresses

Primary practice location

505 Union St
Pella, IA 50219-1719

Mailing address

505 Union St
Pella, IA 50219-1719
Phone (641) 620-5050

Other names 1

  • Hospice of Pella, The Comfort House Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071127000190 IA Part A Provider - Hospice 9931005873 Practice locations: Pella, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215979208. Details of each certification follow.

Hospice certification: CCN 161538

Legal name
PELLA REGIONAL HEALTH CENTER
Doing business as
HOSPICE OF PELLA, THE COMFORT HOUSE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 12, 1995
Last certification
Mar 10, 2022
Ownership / control type
Non-Profit - Private
Organization structure
OtherNon-profit
Incorporated
Jun 1, 1958 in IA
Enrollment address
505 Union St
Pella, IA 50219-1719

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
Hospice of Pella, the Comfort HouseCCN 161538 · All quality measures
Ownership
For-Profit
Certified
Feb 12, 1995
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Pella Medical Clinic13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Robert D Kroese Individual Corporate OfficerChief Executive Officer Nov 21, 2007
W-2 Managing EmployeeCeo Nov 21, 2007 100%
Chad Loren Huyser Individual Corporate DirectorBoard Director Feb 1, 2019 9.1%
James M Brandl Individual Corporate DirectorVice President Jan 1, 2018 9.1%
Stephen Ambrose Barnes Individual Corporate DirectorBoard Director Jan 1, 2020 9.1%
Bruce Alan Heifner Individual Corporate OfficerChief Financial Officer Feb 9, 2015
W-2 Managing EmployeeChief Financial Officer Feb 9, 2015
Randall C Stravers Individual Corporate DirectorBoard Chairman Jan 1, 2017 9.1%
Rodney O Braun Individual Corporate DirectorBoard Director Jan 1, 2013 9.1%
Michael P Morgan Individual Corporate DirectorBoard Director Jan 1, 2014 9.1%
Mary Lou Glendening Individual Corporate DirectorBoard Secretary Jan 1, 2015 9.1%
Leslie Johnston Individual Corporate DirectorBoard Director Apr 1, 2020 9.1%
Craig Allen Wittenberg Individual Corporate DirectorBoard Member Apr 1, 2002 9.1%
Richard Dale Posthuma Individual Corporate DirectorBoard Director Jul 1, 2019 9.1%
Pella Regional Health Center Organization, Pella, IA Non-profit 5% Or Greater Direct Ownership Interest Sep 19, 1996 100%
Operational/Managerial Control Sep 19, 1996 100%
Travis Turnbull Individual Corporate DirectorBoard Treasurer Sep 1, 2019 9.1%

Owners & managing parties with NPI records 12

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Pella Regional Health CenterPella, IA, CCN 161367 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 29, 2013
Aug 29, 2013
Pella Regional Health CenterPella, IA, CCN 16Z367 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 29, 2013
Nov 15, 2007
Pella Regional Home Health AgencyPella, IA, CCN 167220 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 21, 2007
Jan 1, 1994
Sully Family Health CenterSully, IA, CCN 163455 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 1996
Jan 1, 1996
Ottumwa Medical ClinicOttumwa, IA, CCN 168562 Rural health clinic Operational/Managerial Control (100%) Aug 1, 2012
Prairie City Medical ClinicPrairie City, IA, CCN 168660 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Security Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 2017
Jul 1, 2017
Jul 1, 2017

Owned or controlled facilities with NPI records 6

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 9

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": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1215979208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 UNION ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191719",
            "telephone_number": "641-620-5050",
            "fax_number": "641-620-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 UNION ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191719",
            "telephone_number": "641-620-5050",
            "fax_number": "641-620-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELLA REGIONAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "KROESE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "641-628-6604"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IA",
            "license": "630165H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice of Pella, The Comfort House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pella, IA

Sources for this page

Verify at the official NPI Registry.