NPIMap

Organization Active NPI

Peoples Memorial Hospital

Doing business as Buchanan County Health Center

  • Medicare Defined Swing Bed Hospital Unit
  • Independence, IA
National Provider Identifier
1487710497
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
PEOPLES MEMORIAL HOSPITAL
Doing business as
Buchanan County Health Center
Practice address
1600 1St St E
Independence, IA 50644-3155
Phone
(319) 332-0999
Fax
(319) 332-0958
NPI assigned
Dec 28, 2006
Last updated
May 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Authorized official

Name
Wade E Weis
Title
Ceo
Phone
(319) 332-0999

Specialties & licenses 1

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

Addresses

Primary practice location

1600 1St St E
Independence, IA 50644-3155

Mailing address

1600 1St St E
Independence, IA 50644-3155
Phone (319) 332-0999

Other identifiers 2

IdentifierTypeStateIssuer
660860OtherIABLUE CROSS SNF
660860MedicaidIA

Other names 1

  • BUCHANAN COUNTY HEALTH CENTER Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031118000161 IA Part B Supplier - Clinic/Group Practice 9931010790 Receives reassigned benefits from 99 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Independence, IA; Jesup, IA; Oelwein, IA
O20071226000053 IA Part A Provider - Critical Access Hospital 9931010790 Practice locations: Independence, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487710497. Details of each certification follow.

Hospital certification: CCN 16Z335

Legal name
PEOPLES MEMORIAL HOSPITAL
Doing business as
BUCHANAN COUNTY HEALTH CENTER
Organization structure
CorporationNon-profit
Enrollment address
1600 1St St E
Independence, IA 50644-3155
Hospital Swing-Bed Unit

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).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
People's Memorial Hospita8 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 8

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

NameRoleSinceShare
Anne Edgington McMillan Individual Corporate DirectorTrustee Jan 1, 2009
Cynthia S Horn Individual Corporate Director Feb 25, 2026
Vera Cummings Individual W-2 Managing Employee Nov 19, 2007
Donald L Bloes Individual Corporate DirectorTrustee Jul 28, 2015
Robin Robinson Individual Corporate DirectorTrustee Jan 1, 2009
Dennis G Donlea Individual Corporate Officer Dec 4, 2017
Corporate DirectorTrustee Jul 26, 2016
Wade Weis Individual Corporate OfficerCeo Feb 23, 2022
Corporate DirectorCeo Feb 23, 2022
W-2 Managing EmployeeCeo Feb 23, 2022
Anthony M. Fortmann Individual Corporate OfficerCfo Aug 26, 2024
Corporate DirectorCfo Aug 26, 2024
W-2 Managing EmployeeCfo Aug 26, 2024

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1487710497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 1ST ST E",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506443155",
            "telephone_number": "319-332-0999",
            "fax_number": "319-332-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 1ST ST E",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506443155",
            "telephone_number": "319-332-0999",
            "fax_number": "319-332-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEOPLES MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "WEIS",
        "authorized_official_first_name": "WADE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "319-332-0999"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SNF",
            "identifier": "660860",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660860",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BUCHANAN COUNTY HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BUCHANAN COUNTY HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, IA

Sources for this page

Verify at the official NPI Registry.