NPIMap

Organization Active NPI

Belmond Community Hospital

Doing business as Iowa Specialty Hospital-Belmond

  • Medicare Defined Swing Bed Hospital Unit
  • Belmond, IA
National Provider Identifier
1295813806
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
BELMOND COMMUNITY HOSPITAL
Doing business as
Iowa Specialty Hospital-Belmond
Practice address
403 1St St SE
Belmond, IA 50421-1201
Phone
(641) 444-3500
Fax
(641) 444-4896
NPI assigned
Nov 1, 2006
Last updated
Jan 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Authorized official

Name
Amy McDaniel
Title
Ceo
Phone
(641) 444-5621

Specialties & licenses 1

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

Addresses

Primary practice location

403 1St St SE
Belmond, IA 50421-1201

Mailing address

403 1St St SE
Belmond, IA 50421-1201
Phone (641) 444-3500

Other identifiers 1

IdentifierTypeStateIssuer
0600072MedicaidIA

Other names 1

  • Iowa Specialty Hospital-Belmond Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070129000349 IA Part A Provider - Critical Access Hospital 1052201852 Practice locations: Belmond, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295813806. Details of each certification follow.

Hospital certification: CCN 16Z301

Legal name
BELMOND COMMUNITY HOSPITAL
Doing business as
IOWA SPECIALTY HOSPITAL - BELMOND
Organization structure
OtherNon-profit
Enrollment address
403 1St St SE
Belmond, IA 50421-1201

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
Belmond Community Hospi8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Anna Buseman Individual Corporate Director Jan 1, 2024
Gregory C Polzin Individual Corporate Director Oct 4, 2013
Belmond Community Hospital Organization, Belmond, IA Non-profit Operational/Managerial Control Jan 1, 2000 100%
Teri Havens Individual Corporate Director Nov 1, 2013
Brad Robson Individual Corporate Director Jun 1, 2004
Missy Brannick Individual W-2 Managing Employee Nov 29, 2017
Nancy Ann Gabrielson Individual Corporate Director Mar 7, 2019
Troy Watne Individual Corporate Director Jan 27, 2016
Kelly J Leu Individual W-2 Managing Employee Nov 27, 2017
Amy McDaniel Individual Corporate Officer Oct 4, 2013

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Iowa Specialty Hospital-BelmondBelmond, IA, CCN 161301 Hospital Operational/Managerial Control (100%) Dec 27, 2019
Hampton ClinicHampton, IA, CCN 168559 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2000

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1295813806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 1ST ST SE",
            "city": "BELMOND",
            "state": "IA",
            "postal_code": "504211201",
            "telephone_number": "641-444-3500",
            "fax_number": "641-444-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 1ST ST SE",
            "city": "BELMOND",
            "state": "IA",
            "postal_code": "504211201",
            "telephone_number": "641-444-3500",
            "fax_number": "641-444-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELMOND COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-444-5621"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0600072",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Iowa Specialty Hospital-Belmond",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Iowa Specialty Hospital-Belmond",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belmond, IA

Sources for this page

Verify at the official NPI Registry.