NPIMap

Organization Active NPI

County of Van Buren

  • Home Health Agency
  • Keosauqua, IA
National Provider Identifier
1386720563
Registry record updated Feb 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
COUNTY OF VAN BUREN
Practice address
905 Broad St Courthouse
Keosauqua, IA 52565-0514
Phone
(319) 293-3431
Fax
(319) 293-3609
NPI assigned
Oct 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2010

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

Authorized official

Name
Ms. Lindee J Thomas, RN
Title
Nurse Administrator
Phone
(319) 293-3431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

905 Broad St Courthouse
Keosauqua, IA 52565-0514

Mailing address

PO Box 514
905 Broad St
Keosauqua, IA 52565-0514
Phone (319) 293-3431

Other identifiers 2

IdentifierTypeStateIssuer
67111OtherIABCBS OF IA
0671115MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100317000608 IA Part A Provider - Home Health Agency 7911032818 Practice locations: Keosauqua, IA
O20240301000706 IA Part B Supplier - Clinic/Group Practice 7911032818 Practice locations: Keosauqua, IA

Home health agency certification: CCN 167111

Legal name
COUNTY OF VAN BUREN
Doing business as
VAN BUREN COUNTY PHNS
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 23, 1979
Last certification
Nov 18, 2020
Ownership / control type
Government Operated
Organization structure
OtherNon-profit
Incorporated
May 24, 1979 in IA
Enrollment address
404 Dodge St
Keosauqua, IA 52565-7728

Care Compare: Home health agency

Medicare Care Compare
Listed as
Van Buren County PHNSCCN 167111
Ownership
Government Operated
Certified
May 23, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0648143Van Buren County PHNS404 Dodge Street, Keosauqua, IA 52565Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

905 Broad St
Keosauqua, IA 52565
Phone (319) 293-3431

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Lindee J Thomas Individual W-2 Managing Employee Jan 4, 2010
Operational/Managerial ControlAdministrator Feb 22, 2012
County of Van Buren Organization, Keosauqua, IA 5% Or Greater Direct Ownership Interest Jan 4, 2010 100%

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266796800000",
    "number": "1386720563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 514",
            "address_2": "905 BROAD ST",
            "city": "KEOSAUQUA",
            "state": "IA",
            "postal_code": "525650514",
            "telephone_number": "319-293-3431",
            "fax_number": "319-293-3609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 BROAD ST COURTHOUSE",
            "city": "KEOSAUQUA",
            "state": "IA",
            "postal_code": "525650514",
            "telephone_number": "319-293-3431",
            "fax_number": "319-293-3609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF VAN BUREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2010-02-22",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "LINDEE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "NURSE ADMINISTRATOR",
        "authorized_official_telephone_number": "319-293-3431",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IA",
            "identifier": "67111",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0671115",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keosauqua, IA

Sources for this page

Verify at the official NPI Registry.