Pella Regional Health Center
Organization Active NPI Home Health Agency · Pella, IA
NPI 1295778140 · NPPES record last updated Oct 20, 2014
Key facts
- NPI
- 1295778140
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 630165H (IA)
- Legal business name
- PELLA REGIONAL HEALTH CENTER
- Practice address
- 505 Union St
Pella, IA 50219-1719 - Phone
- (641) 628-6638
- NPI assigned
- Jun 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Robert D Kroese
- Title
- Ceo
- Phone
- (641) 628-6604
Owners & managing parties with NPI records 12
-
Stephen Ambrose Barnes, D.O.
Owned or controlled facilities with NPI records 6
Other NPIs with the same Medicare PAC ID 9
Corporate family (same tax ID) 12
Facilities with the same owner 6
Practitioners 96
-
Marsha Collins, PA-C
-
Jamie M. Amble, CNP
-
Chelsey Elaine Ballard, PA-C
-
Russell Evan Bandstra, M.D.
-
Stephen Ambrose Barnes, D.O.
-
Rebecca S Bartelma, DPT
-
Bradley J. Beattie III, PA-C
-
Kimberly C Bina, D.O.
-
Brenda Kay Birdsell, OTR
-
Mitchell Lee Blom, D.O.
-
Summer Denise Brown, ARNP
-
Charles R Canedy IV, M.D.
-
David K Carroll, P.T.
-
Ronald R. Childerston, D.O.
-
Danielle K Clark, D.O.
-
Joseph Ira Coleman, M.D.
-
Marcy Michelle Covert, FNP-C
-
Allison Marie Crall, ARNP
-
Shelby Dames, M.D.
-
Dustin David Derflinger, D.O.
-
Daniel Lee Dodge, DO
-
Emory Dye, M.D.
Affiliated clinicians 8
-
Chelsey Elaine Ballard, PA-C
-
Mitchell Lee Blom, D.O.
-
Danielle K Clark, D.O.
-
Molly Engelhart, DNP, ARNP
-
Maria Luz Lao, MD
Medicare Care Compare: Home health agency
- Listed as
- Pella Regional Home Health Agency
- Overall star rating
- ★★★☆☆ 3 of 5
- Ownership
- Non-Profit
- Certified
- Mar 11, 1994
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
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
- Other · Non-profit
- Incorporated
- Jun 1, 1958 in IA
- Enrollment address
- 505 Union Street
Pella, IA 50219-1719
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Robert D Kroese |
Corporate Officer |
Nov 21, 2007 | |
| W-2 Managing Employee | Nov 21, 2007 | ||
| Chad Loren Huyser |
Corporate Director |
Feb 1, 2019 | 9.1% |
| James M Brandl |
Corporate Director |
Jan 1, 2018 | 9.1% |
| Stephen Ambrose Barnes |
Corporate Director |
Jan 1, 2020 | 9.1% |
| Bruce Alan Heifner |
Corporate Officer |
Feb 9, 2015 | |
| W-2 Managing Employee |
Feb 9, 2015 | ||
| Randall C Stravers |
Corporate Director |
Jan 1, 2017 | 9.1% |
| Rodney O Braun |
Corporate Director |
Jan 1, 2013 | 9.1% |
| Michael P Morgan |
Corporate Director |
Jan 1, 2014 | 9.1% |
| Erica K Marvelli |
W-2 Managing Employee |
May 2, 2016 | |
| Mary Lou Glendening |
Corporate Director |
Jan 1, 2015 | 9.1% |
| Leslie Johnston |
Corporate Director |
Apr 1, 2020 | 9.1% |
| Craig Allen Wittenberg |
Corporate Director |
Nov 21, 2007 | 9.1% |
| Richard Dale Posthuma |
Corporate Director |
Jul 1, 2019 | 9.1% |
| Pella Regional Health Center |
5% Or Greater Direct Ownership Interest | Nov 21, 2007 | 100% |
| Operational/Managerial Control | Jan 1, 1994 | 100% | |
| Travis Turnbull |
Corporate Director |
Sep 1, 2019 | 9.1% |
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Pella Regional Health Center |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Aug 29, 2013 Aug 29, 2013 |
| Pella Regional Health Center |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Aug 29, 2013 Nov 15, 2007 |
| Hospice of Pella, the Comfort House |
Hospice | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Sep 19, 1996 Sep 19, 1996 |
| Sully Family Health Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Jan 1, 1996 Jan 1, 1996 |
| Ottumwa Medical Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Aug 1, 2012 |
| Prairie City Medical Clinic |
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 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071127000184 | IA | Part a Provider - Home Health Agency | 9931005873 | Practice locations: Pella, IA |
National Provider Directory
- Tax ID family
- Pella HLTH Ctr Med Clin
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 630165H | IA | Yes |
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
- Pella Regional Home Health Agency
Other providers in Pella, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2014. 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.