NPIMap

Organization Active NPI

Alegent Health Community Memorial Hospital of Missouri Valley, Iowa

  • Critical Access Hospital
  • Missouri Valley, IA
National Provider Identifier
1508964123
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
430030 Issued in IA
Legal business name
ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA
Practice address
631 N 8TH St
Missouri Valley, IA 51555-1102
Phone
(712) 642-2784
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Authorized official

Name
Evert Kuiper
Title
Ceo - CHI Health
Phone
(402) 343-4420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 430030 IA Primary

Addresses

Primary practice location

631 N 8TH St
Missouri Valley, IA 51555-1102

Mailing address

PO Box 776220
Chicago, IL 60677-6220

Other identifiers 1

IdentifierTypeStateIssuer
430030OtherHOSPITAL LICENSE NUMBER

Other names 1

  • CHI Health Missouri Valley Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110608000049 IA Part A Provider - Critical Access Hospital 3678482130 Receives reassigned benefits from 27 practitioners
Practice locations: Missouri Valley, IA

Hospital certification: CCN 161309

Legal name
ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY IOWA
Doing business as
CHI HEALTH MISSOURI VALLEY
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 1, 2000
Last certification
Jun 1, 2023
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 22, 1955 in IA
Enrollment address
631 N 8TH St
Missouri Valley, IA 51555-1102
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 7

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

Care Compare: Hospital

Medicare Care Compare
Listed as
CHI Health Missouri ValleyCCN 161309
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Alegent Health Comm Mem8 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 17

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

NameRoleSinceShare
CHI Nebraska Organization, Omaha, NE Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 2013 100%
Marvin O'Quinn Individual OtherCSH Home Office Administrator Aug 1, 2022
Nadine a Heimann Individual Corporate Director Jul 1, 2019
Maurita Soukup Individual Corporate Director Jul 1, 2017
Commonspirit Health Organization, Englewood, CO Corporation 5% Or Greater Indirect Ownership Interest Aug 1, 2013 100%
David Jones Individual Operational/Managerial ControlPresident Apr 17, 2021
William Barney Individual Corporate Director Jul 1, 2020
Kevin Fitzgerald Individual Corporate DirectorBod Jul 15, 2021
Suzanne L Hruza Individual Corporate DirectorBoard Member Sep 18, 2014
Nick O'Tool Individual Operational/Managerial ControlInterim Cfo - CHI Health Jan 7, 2023
Heather M Morgan Individual Corporate Director Jul 1, 2020
Kirtibala Gupta Individual Corporate DirectorBod Jul 15, 2021
Evert Kuiper Individual Corporate DirectorCeo - CHI Health Jan 17, 2022
Operational/Managerial ControlCeo - CHI Health Jan 17, 2022
John E Petersdorf Individual Corporate Director Jan 21, 2021
William Yates Individual Corporate Director Oct 1, 2015
Mardell Wilson Individual Corporate Director Oct 15, 2020
Kelly Bacon Individual Corporate DirectorBod Jul 15, 2021

Owners & managing parties with NPI records 3

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

Facilities with the same owner 38

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

View all 38

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 36

Affiliated clinicians 86

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

View all 86

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1508964123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776220",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 N 8TH ST",
            "city": "MISSOURI VALLEY",
            "state": "IA",
            "postal_code": "515551102",
            "telephone_number": "712-642-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "KUIPER",
        "authorized_official_first_name": "EVERT",
        "authorized_official_title_or_position": "CEO - CHI HEALTH",
        "authorized_official_telephone_number": "402-343-4420"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IA",
            "license": "430030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL LICENSE NUMBER",
            "identifier": "430030",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI Health Missouri Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHI Health Missouri Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Missouri Valley, IA

Sources for this page

Verify at the official NPI Registry.