Kanawha Community Home, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

410433 Issued in IA

Legal business name

KANAWHA COMMUNITY HOME, INC

Practice address

130 W 6TH St
Kanawha, IA 50447-5026

Phone

(641) 762-3302

NPI assigned

Jan 31, 2006

Last updated

Feb 14, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Allen Youmans

Title

Administrator

Phone

(641) 762-3302

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396716965. Details of each certification follow.

• CCN 165467 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 165467

Legal name

KANAWHA COMMUNITY HOME, INC

Doing business as

KANAWHA COMMUNITY HOME, INC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 1, 2002

Last certification

Oct 17, 2024

Beds

26

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Enrollment address

130 W 6TH St
Kanawha, IA 50447-5026

Nursing home name

KANAWHA COMMUNITY HOME, INC.

Listed as

Kanawha Community Home, INC.CCN 165467 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

5 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Aug 1, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

2617.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 29

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

Owners & managing parties with NPI records 4

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

• Jon S Ahrendsen, M.D.

  • Family Medicine Physician
  • Clarion, IA
  • NPI 1326036062

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Millennium Rehab & Consulting, Inc.

  dba Millennium Therapy

  • Physical Therapist
  • Des Moines, IA
  • NPI 1255385852

  Adp of the SNF

  CMS ownership
• Millennium Rehab & Consulting, Inc.

  dba Millennium Therapy

  • Physical Therapist
  • Independence, IA
  • NPI 1336193986

  Adp of the SNF

  CMS ownership
• Millennium Rehab & Consulting, Inc.

  dba Millennium Therapy

  • Physical Therapist
  • Fort Dodge, IA
  • NPI 1376597708

  Adp of the SNF

  CMS ownership

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.

• Michael Steinkruger

  • Skilled Nursing Facility
  • Greene, IA
  • NPI 1104201631
  NPD

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jon S Ahrendsen, M.D.

  • Family Medicine Physician
  • Clarion, IA
  • NPI 1326036062

  Nursing home

  Care Compare affiliation
• Catherine E Butler, MD

  • Family Medicine Physician
  • Britt, IA
  • NPI 1174558860

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392336000000",
    "number": "1396716965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W 6TH ST",
            "city": "KANAWHA",
            "state": "IA",
            "postal_code": "504475026",
            "telephone_number": "641-762-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W 6TH ST",
            "city": "KANAWHA",
            "state": "IA",
            "postal_code": "504475026",
            "telephone_number": "641-762-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANAWHA COMMUNITY HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2014-02-14",
        "status": "A",
        "authorized_official_last_name": "YOUMANS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "641-762-3302",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "410433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0802116",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING FACILITY LICENSE",
            "identifier": "410433",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cartee Care Transportation LLC (CCT)
• Tiffany Anne Cartee

• Skilled Nursing Facility in Kanawha, IA
• Providers in Kanawha, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.