NPIMap

Organization Active NPI

Pella Regional Health Center

Doing business as Pella Regional Home Health Agency

  • Home Health Agency
  • Pella, IA
National Provider Identifier
1295778140
Registry record updated Oct 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
630165H Issued in IA
Legal business name
PELLA REGIONAL HEALTH CENTER
Doing business as
Pella Regional Home Health Agency
Practice address
505 Union St
Pella, IA 50219-1719
Phone
(641) 628-6638
NPI assigned
Jun 14, 2006
Last updated
Oct 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2014

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

Authorized official

Name
Robert D Kroese
Title
Ceo
Phone
(641) 628-6604

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 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) 628-6638

Other names 1

  • Pella Regional Home Health Agency Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071127000184 IA Part A Provider - Home Health Agency 9931005873 Practice locations: Pella, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295778140. Details of each certification follow.

Home health agency certification: CCN 167220

Legal name
PELLA REGIONAL HEALTH CENTER
Doing business as
PELLA REGIONAL HOME HEALTH AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 11, 1994
Last certification
Feb 19, 2020
Ownership / control type
Non-Profit
Organization structure
OtherNon-profit
Incorporated
Jun 1, 1958 in IA
Enrollment address
505 Union Street
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: Home health agency

Medicare Care Compare
Listed as
Pella Regional Home Health AgencyCCN 167220 · All quality measures
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Mar 11, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology

National Provider Directory

National Provider Directory
Tax ID family
Pella Regional HLTH Ctr13 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 15

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 Employee Nov 21, 2007
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%
Erica K Marvelli Individual W-2 Managing EmployeeManager of Home Health May 2, 2016
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 Nov 21, 2007 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 Nov 21, 2007 100%
Operational/Managerial Control Jan 1, 1994 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
Hospice of Pella, the Comfort HousePella, IA, CCN 161538 Hospice 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 19, 1996
Sep 19, 1996
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 8

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": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413763200000",
    "number": "1295778140",
    "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": "641-628-6638"
        },
        {
            "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": "641-628-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELLA REGIONAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-10-20",
        "status": "A",
        "authorized_official_last_name": "KROESE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-628-6604"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IA",
            "license": "630165H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pella Regional Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pella, IA

Sources for this page

Verify at the official NPI Registry.