Iowa River Hospice Inc

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

IOWA RIVER HOSPICE INC

Practice address

502 Plaza Heights Rd
Marshalltown, IA 50158-4544

Phone

(641) 753-7704

Fax

(641) 753-0379

NPI assigned

Sep 22, 2005

Last updated

Oct 25, 2013By 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

Joyce Ann Stupp

Title

Office Manager

Phone

(641) 753-7704

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 1396731535. Details of each certification follow.

• CCN 161505 Hospice · Active · Details

Hospice certification: CCN 161505

Legal name

IOWA RIVER HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Feb 28, 1986

Last certification

Jun 24, 2021

Ownership / control type

Non-Profit - Private

Organization structure

CorporationNon-profit

Incorporated

Jan 28, 1983 in IA

Enrollment address

502 Plaza Heights Rd
Marshalltown, IA 50158-4544

Listed as

Iowa River HospiceCCN 161505 · All quality measures

Ownership

Non-Profit

Certified

Feb 28, 1986

Medicare certification status

ActiveFrom the Provider of Services file

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 6

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 1

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

• Timothy Wayne Swinton, M.D.

  • Family Medicine Physician
  • Marshalltown, IA
  • NPI 1245388743

  Contracted Managing Employee

  CMS ownership

Practitioners 2

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.

• Ann Marie Ersland, ARNP

  • Nurse Practitioner
  • Marshalltown, IA
  • NPI 1407477714
  NPD (past)
• Ronald J Pelz, PSYD

  • Clinical Child & Adolescent Psychologist
  • Conway, AR
  • NPI 1538253059
  NPD (past)

Affiliated clinicians 6

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

• Lynne Janine Desotel, MD

  • Family Medicine Physician
  • Marshalltown, IA
  • NPI 1568545960

  Hospice

  Care Compare affiliation
• Laura Ellen Lasack, MD

  • Family Medicine Physician
  • Marshalltown, IA
  • NPI 1861468084

  Hospice

  Care Compare affiliation
• Joseph James Merchant, M.D.

  • Hematology & Oncology Physician
  • Ames, IA
  • NPI 1699765826

  Hospice

  Care Compare affiliation
• Maria L.M. Olberding, M.D.

  • Family Medicine Physician
  • Marshalltown, IA
  • NPI 1003807900

  Hospice

  Care Compare affiliation
• Joseph Clair Pollpeter, M.D.

  • Family Medicine Physician
  • Marshalltown, IA
  • NPI 1700877164

  Hospice

  Care Compare affiliation
• Steve T. Scurr, D.O.

  • Family Medicine Physician
  • Conrad, IA
  • NPI 1053398800

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382659200000",
    "number": "1396731535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 PLAZA HEIGHTS RD",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501584544",
            "telephone_number": "641-753-7704",
            "fax_number": "641-753-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 PLAZA HEIGHTS RD",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501584544",
            "telephone_number": "641-753-7704",
            "fax_number": "641-753-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA RIVER HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2013-10-25",
        "status": "A",
        "authorized_official_last_name": "STUPP",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "641-753-7704"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "61505",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0615054",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Marshalltown, IA
• Providers in Marshalltown, IA by specialty
• Exclusive Provider Organization in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; 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.