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Organization Active NPI

Ida County Iowa Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Ida Grove, IA
National Provider Identifier
1275609166
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
IDA COUNTY IOWA COMMUNITY HOSPITAL
Practice address
701 E 2ND St
Ida Grove, IA 51445-1699
Phone
(712) 364-3311
Fax
(712) 364-3363
NPI assigned
Nov 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Authorized official

Name
Joni G. Schumann
Title
Cfo
Phone
(712) 364-3311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

701 E 2ND St
Ida Grove, IA 51445-1699

Mailing address

701 E 2ND St
Ida Grove, IA 51445-1699
Phone (712) 364-3311

Other identifiers 2

IdentifierTypeStateIssuer
0655241MedicaidIA
66131OtherIABLUE CROSS

Other names 1

  • Horn Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070201000120 IA Part A Provider - Critical Access Hospital 9537070826 Practice locations: Ida Grove, IA

Hospital certification: CCN 16Z354

Legal name
IDA COUNTY IOWA COMMUNITY HOSPITAL
Doing business as
HORN MEMORIAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Nov 25, 1960 in IA
Enrollment address
701 E 2ND St
Ida Grove, IA 51445-1699
Hospital Swing-Bed Unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hosp Pulmonhor9 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 13

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

NameRoleSinceShare
Shannon M Fox Individual Corporate OfficerCfo May 1, 2024
W-2 Managing EmployeeCfo May 1, 2024
Operational/Managerial ControlCfo May 1, 2024
Curtis R Hesse Individual W-2 Managing EmployeeChief of Staff Jan 1, 2022
Operational/Managerial ControlChief of Staff Jan 1, 2022
Denise D Redenius Individual Corporate Officer May 19, 2025
Corporate Director Apr 24, 2023
Kristeen R Gunderson Individual Corporate Director May 23, 2022
Cole Boger Individual Corporate Officer May 23, 2022
Corporate Director Jun 22, 2020
David Forbes Individual Corporate Director Apr 23, 2018
Robert D Paulsen Individual Corporate Officer May 19, 2025
Corporate Director Apr 25, 2022
Emily Lange Individual Corporate OfficerCco/Cno Dec 6, 2020
W-2 Managing EmployeeCco/Cno Dec 6, 2020
Operational/Managerial ControlCco/Cno Dec 6, 2020
Vance Lundell Individual Corporate Director Apr 23, 2018
Jeffrey D Buehler Individual Corporate Director Apr 25, 2025
Kelli Boyle Individual Corporate Officer May 23, 2022
Corporate Director Apr 23, 2018
Glen Winekauf Individual Corporate OfficerCeo Sep 14, 2017
W-2 Managing EmployeeCeo Sep 14, 2017
Operational/Managerial ControlCeo Sep 14, 2017
Christina Kjar Hanson Individual Corporate Director Apr 22, 2019

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

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": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1275609166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E 2ND ST",
            "city": "IDA GROVE",
            "state": "IA",
            "postal_code": "514451699",
            "telephone_number": "712-364-3311",
            "fax_number": "712-364-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E 2ND ST",
            "city": "IDA GROVE",
            "state": "IA",
            "postal_code": "514451699",
            "telephone_number": "712-364-3311",
            "fax_number": "712-364-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDA COUNTY IOWA COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "SCHUMANN",
        "authorized_official_first_name": "JONI",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "712-364-3311"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0655241",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "66131",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horn Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Horn Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ida Grove, IA

Sources for this page

Verify at the official NPI Registry.