NPIMap

Organization Active NPI

Hamilton County Public Hospital

Doing business as Van Diest Medical Center Stratford Clinic

  • Rural Health Clinic/Center
  • Stratford, IA
National Provider Identifier
1497957351
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HAMILTON COUNTY PUBLIC HOSPITAL
Doing business as
Van Diest Medical Center Stratford Clinic
Practice address
817 Shakespeare Ave
Stratford, IA 50249-7774
Phone
(515) 838-2100
NPI assigned
Jun 4, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
HAMILTON COUNTY PUBLIC HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Alice Heinrichs, CFO
Title
Cfo
Phone
(515) 832-9400

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

817 Shakespeare Ave
Stratford, IA 50249-7774

Mailing address

PO Box 430
Webster City, IA 50595-0430
Phone (515) 832-9400

Other names 1

  • Van Diest Medical Center Stratford Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031216000775 IA Part B Supplier - Clinic/Group Practice 1254241565 Receives reassigned benefits from 78 practitioners
7 other NPIs on this enrollment
Practice locations: Webster City, IA; Stratford, IA; Jewell, IA; Fort Dodge, IA
O20061104000151 IA Part A Provider - Critical Access Hospital 1254241565 Receives reassigned benefits from 77 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Webster City, IA
O20170615001439 IA Part A Provider - Rural Health Clinic 1254241565 Practice locations: Stratford, IA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1497957351. Details of each certification follow.

Hospital certification: CCN 161361

Legal name
HAMILTON COUNTY PUBLIC HOSPITAL
Doing business as
VAN DIEST MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 1, 2004
Last certification
Sep 15, 2022
Beds
25
Ownership / control type
Other
Organization structure
GovernmentNon-profit
Enrollment address
2350 Hospital Dr
Webster City, IA 50595-6600

Rural health clinic certification: CCN 168591

Legal name
HAMILTON COUNTY PUBLIC HOSPITAL
Doing business as
VAN DIEST MEDICAL CENTER STRATFORD CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 13, 2017
Last certification
Sep 13, 2017
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
817 Shakespeare Ave
Stratford, IA 50249-7774
Related CCNs
161361

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Van Diest Medical CenterCCN 161361 · All quality measures
Overall star rating
5 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
16D1070292Van Diest Medical Center - Stratford Clinic817 Shakespeare, Stratford, IA 50249Certificate of waiverOct 31, 2027

National Provider Directory

National Provider Directory
Part of
Hamilton County Public Hospital

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Kyle Martin Heffernan Individual Operational/Managerial ControlBoard Member Jan 28, 2020
Corporate OfficerBoard Member Jan 28, 2020
Amy McDonough Individual Corporate DirectorCno Jan 3, 2018
Corporate OfficerCno Jan 3, 2018
W-2 Managing EmployeeCno Jan 3, 2018
Operational/Managerial ControlCno Jan 3, 2018
David Everson Individual Corporate DirectorBoard Member May 26, 2020
Darcy Swon Individual Corporate OfficerBoard Member Jul 28, 2015
Corporate Director Jul 28, 2015
Ashley N Allers Individual Corporate OfficerCfo Apr 1, 2022
W-2 Managing EmployeeCfo Jan 16, 2012
Kirk McCollough Individual Corporate OfficerBoard Member Jan 20, 2015
Corporate Officer Jan 1, 2017
Corporate Director Jan 20, 2015
Mercy Health Network Inc Organization, Clive, IA Non-profit Operational/Managerial Control Jul 1, 2010
Carroll D Ose Individual Corporate OfficerBoard Chair Jan 2, 2013
Corporate Officer Jan 1, 2017
Corporate Director Jan 2, 2013
Lisa Ridge Individual Contracted Managing EmployeeCeo Oct 1, 2017
Corporate OfficerCeo Oct 1, 2017
Corporate OfficerCno May 16, 2017
Operational/Managerial ControlCno Aug 15, 2016
Michelle Zahn Individual Corporate DirectorBoard Member Aug 23, 2022
Nicole L Ehn Individual W-2 Managing EmployeeMedical Director Oct 1, 2016
Operational/Managerial ControlMedical Director Jun 16, 2018
Leigh Miller Individual W-2 Managing EmployeeClinic Director Sep 27, 2017
Operational/Managerial ControlClinic Director Sep 27, 2017

Owners & managing parties with NPI records 2

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

Facilities with the same owner 98

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

View all 98

Practitioners & affiliated clinicians

Practitioners 80

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.

View all 80

Affiliated clinicians 110

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

View all 110

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497957351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430",
            "city": "WEBSTER CITY",
            "state": "IA",
            "postal_code": "505950430",
            "telephone_number": "515-832-9400",
            "fax_number": "515-832-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 SHAKESPEARE AVE",
            "city": "STRATFORD",
            "state": "IA",
            "postal_code": "502497774",
            "telephone_number": "515-838-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMILTON COUNTY PUBLIC HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAMILTON COUNTY PUBLIC HOSPITAL",
        "enumeration_date": "2007-06-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HEINRICHS",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "515-832-9400",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Van Diest Medical Center Stratford Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stratford, IA

Sources for this page

Verify at the official NPI Registry.