Active NPI
Lutheran Retirement Home, Inc.
- Skilled Nursing Facility
- Northwood, IA
On this page
- Key facts
- Authorized official
- Owners & managing parties with NPI records9
- Affiliated clinicians2
- Care Compare: Nursing home
- Laboratory certificates & supplier records
- Medicare participation
- Skilled nursing facility certification: CCN 165485
- All disclosed owners & managing parties78
- Medicare enrollment records1
- National Provider Directory
- Specialties & licenses3
- Addresses
- Other identifiers3
- NPI Registry JSON
- Other providers in Northwood, IA
- Sources for this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 980326
- Legal business name
- LUTHERAN RETIREMENT HOME, INC.
- Practice address
- 701 9TH St N
Northwood, IA 50459-1004 - Phone
- (641) 324-1712
- Fax
- (641) 324-3091
- NPI assigned
- Aug 31, 2005
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Mr. Scott Halbach
- Title
- Administrator
- Phone
- (641) 324-1712
Owners & managing parties with NPI records 9
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Durable Medical Equipment & Medical Supplies
- Mason City, IA
- NPI 1164475224
Adp of the SNF
-
- Durable Medical Equipment & Medical Supplies
- Mason City, IA
- NPI 1174579825
Adp of the SNF
-
- Durable Medical Equipment & Medical Supplies
- Osage, IA
- NPI 1710394119
Adp of the SNF
-
- Durable Medical Equipment & Medical Supplies
- Mason City, IA
- NPI 1831142801
Adp of the SNF
-
- Oxygen Equipment & Supplies (DME)
- Albert Lea, MN
- NPI 1629723598
Adp of the SNF
-
- Family Medicine Physician
- Blue Earth, MN
- NPI 1184159014
Adp of the SNF, Operational/Managerial Control
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Lutheran Retirement Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Church related
- Certified
- May 1, 2003
- Medicare certification status
- Active
- Certified beds
- 42
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D0713606 | Lutheran Retirement Home | Certificate of waiver | Aug 31, 2026 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Skilled nursing facility certification: CCN 165485
Medicare enrollment files- Legal name
- LUTHERAN RETIREMENT HOME INC.
- Doing business as
- LUTHERAN RETIREMENT HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 1, 2003
- Last certification
- Jan 30, 2025
- Beds
- 42
- Ownership / control type
- Church Related
- Organization structure
- Corporation
- Enrollment address
- 701 9TH St N
Northwood, IA 50459-1093 - Nursing home name
- LUTHERAN RETIREMENT HOME
All disclosed owners & managing parties 78
Medicare enrollment filesAs disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Carolyn Loftaas | Corporate Director | Jan 20, 2021 | |
| Brittany R Waletzko Bartz | Operational/Managerial Control | Jun 1, 2022 | |
| Adp of the SNF | Oct 10, 2025 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Jerry Brunsvold | Corporate Director | Jan 1, 2025 | |
| Adp of the SNF | Jun 29, 2007 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Jun 29, 2007 | ||
| Adp of the SNF | May 7, 2021 | ||
| Cliftonlarsonallen LLP | Adp of the SNF | Aug 25, 2021 | |
| Adp of the SNF | Jun 29, 2007 | ||
| Adp of the SNF | Jun 29, 2007 | ||
| Adp of the SNF | May 27, 2021 | ||
| Adp of the SNF | Jun 29, 2007 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | May 27, 2021 | ||
| Adp of the SNF | Jun 30, 2024 | ||
| Adp of the SNF | Nov 2, 2022 | ||
| Adp of the SNF | Jun 30, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Brian Nelson | Corporate Officer | Jan 10, 2017 | |
| Adp of the SNF | Oct 1, 2024 | ||
| NSB Bank | 5% Or Greater Security Interest | Jun 29, 2007 | 28.6% |
| Adp of the SNF | Jun 29, 2007 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | May 27, 2021 | ||
| Fox Rehab SLP Ia PLLC | Adp of the SNF | Jun 30, 2024 | |
| Adp of the SNF | Jun 29, 2007 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | May 27, 2021 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | May 27, 2021 | ||
| Adp of the SNF | Jun 29, 2007 | ||
| Cattail Inc | Adp of the SNF | Oct 1, 2024 | |
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | May 27, 2021 | ||
| Katelyn Thofson | Operational/Managerial Control | May 5, 2014 | |
| BCG Holdings Inc | Adp of the SNF | Oct 1, 2024 | |
| Iowa Health Care Association | Adp of the SNF | Oct 1, 2024 | |
| Fox Rehab PT Ia PLLC | Adp of the SNF | Jun 30, 2024 | |
| Adp of the SNF | Jun 30, 2024 | ||
| Nancy Schrupp | Operational/Managerial Control | Aug 31, 2009 | |
| Sharina Winter | Operational/Managerial Control | Nov 4, 2024 | |
| Adp of the SNF | Oct 10, 2025 | ||
| Mari Kroneman | Corporate Director | Jan 1, 2023 | |
| Fox Rehab OT Ia LLC | Adp of the SNF | Jun 30, 2024 | |
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | May 27, 2021 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Robert Lamp | Operational/Managerial Control | Mar 25, 2024 | |
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Ecsi Inc | Adp of the SNF | Oct 1, 2024 | |
| Peter Julseth | Corporate Officer | Jan 20, 2022 | |
| Lynn Davis | Corporate Officer | Jan 1, 2005 | |
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | May 27, 2021 | ||
| Timothy Knutson | Corporate Director | Jan 20, 2024 | |
| Adp of the SNF | Jun 29, 2007 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Jun 29, 2007 | ||
| Adp of the SNF | Jun 29, 2007 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Ruth Merchant | Operational/Managerial Control | May 20, 2025 | |
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Kevin Bidne | Corporate Director | Jun 1, 2025 | |
| Josh Steinberg | Corporate Director | Jan 20, 2022 | |
| Adp of the SNF | Oct 1, 2024 | ||
| Mercy Health Services- Iowa Corp | Adp of the SNF | May 27, 2021 | |
| Next Generation Technologies | Adp of the SNF | Nov 2, 2022 | |
| Adp of the SNF | May 27, 2021 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | May 27, 2021 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Cassie Davis | Operational/Managerial Control | Apr 2, 2018 | |
| Cattail BCG LLC | Adp of the SNF | Oct 1, 2024 | |
| Brighton Consulting Group LLC | Adp of the SNF | Oct 1, 2024 |
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030203000031 | IA | Part a Provider - Skilled Nursing Facility | 7911816616 | Practice locations: Northwood, IA |
National Provider Directory
National Provider DirectorySpecialties & licenses 3
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Alzheimer Center (Dementia Center) | 311500000X | 980326 | IA | |
| Nursing Facility/Intermediate Care Facility | 313M00000X | 980326 | IA | |
| Skilled Nursing Facility | 314000000X | 980326 | IA | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
701 9TH St N
Northwood, IA 50459-1004
Mailing address
701 9TH St N
PO Box 108
Northwood, IA 50459-0108
Phone (641) 324-1712
Other identifiers 3
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0802355 | Medicaid | IA | |
| 03173110 | Other | IA | AMERIGROUP |
| 65485 | Other | IA | BCBS OF IOWA |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 16, 2020.
{
"created_epoch": "1125446400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1600214400000",
"number": "1528051901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 9TH ST N",
"address_2": "PO BOX 108",
"city": "NORTHWOOD",
"state": "IA",
"postal_code": "504590108",
"telephone_number": "641-324-1712",
"fax_number": "641-324-3091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 9TH ST N",
"city": "NORTHWOOD",
"state": "IA",
"postal_code": "504591004",
"telephone_number": "641-324-1712",
"fax_number": "641-324-3091"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LUTHERAN RETIREMENT HOME, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-31",
"last_updated": "2020-09-16",
"certification_date": "2020-09-16",
"status": "A",
"authorized_official_last_name": "HALBACH",
"authorized_official_first_name": "SCOTT",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "641-324-1712",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "311500000X",
"taxonomy_group": "",
"desc": "Alzheimer Center (Dementia Center)",
"state": "IA",
"license": "980326",
"primary": false
},
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "IA",
"license": "980326",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "IA",
"license": "980326",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0802355",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "03173110",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF IOWA",
"identifier": "65485",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Northwood, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.