Organization Active NPI

Lutheran Retirement Home, Inc.

  • Skilled Nursing Facility
  • Northwood, IA
National Provider Identifier
1528051901
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
980326 Issued in IA
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.

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 HomeCCN 165485
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
May 1, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4234.5 residents per day on average
Penalties (3 years)
1Fines totaling $24,922

Processed by Care Compare on Aug 1, 2026.

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
16D0713606Lutheran Retirement Home701 Ninth Street North, Northwood, IA 50459Certificate of waiverAug 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
CorporationNon-profit
Enrollment address
701 9TH St N
Northwood, IA 50459-1093
Nursing home name
LUTHERAN RETIREMENT HOME

All disclosed owners & managing parties 78

Medicare enrollment files

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

NameRoleSinceShare
Carolyn Loftaas Individual Corporate DirectorBoard Member Jan 20, 2021
Brittany R Waletzko Bartz Individual Operational/Managerial Control Jun 1, 2022
Adp of the SNF Oct 10, 2025
Individual Adp of the SNF Oct 1, 2024
Jerry Brunsvold Individual Corporate DirectorBoard Member Jan 1, 2025
Individual Adp of the SNF Jun 29, 2007
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF Jun 29, 2007
Individual Adp of the SNF May 7, 2021
Cliftonlarsonallen LLP Organization, Chicago, IL Consulting firm Adp of the SNF Aug 25, 2021
Individual Adp of the SNF Jun 29, 2007
Individual Adp of the SNF Jun 29, 2007
Individual Adp of the SNF May 27, 2021
Individual Adp of the SNF Jun 29, 2007
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF May 27, 2021
Individual Adp of the SNF Jun 30, 2024
Individual Adp of the SNF Nov 2, 2022
Individual Adp of the SNF Jun 30, 2024
Individual Adp of the SNF Oct 1, 2024
Brian Nelson Individual Corporate OfficerBoard President Jan 10, 2017
Individual Adp of the SNF Oct 1, 2024
NSB Bank Organization, Northwood, IA Financial institution, Owned by another organization or individual 5% Or Greater Security Interest Jun 29, 2007 28.6%
Adp of the SNF Jun 29, 2007
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF May 27, 2021
Fox Rehab SLP Ia PLLC Organization, Cherry Hill, NJ LLC, Consulting firm Adp of the SNF Jun 30, 2024
Individual Adp of the SNF Jun 29, 2007
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF May 27, 2021
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF May 27, 2021
Individual Adp of the SNF Jun 29, 2007
Cattail Inc Organization, Muscatine, IA Corporation Adp of the SNF Oct 1, 2024
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF May 27, 2021
Katelyn Thofson Individual Operational/Managerial Control May 5, 2014
BCG Holdings Inc Organization, Waukee, IA Corporation Adp of the SNF Oct 1, 2024
Iowa Health Care Association Organization, West Des Moines, IA Corporation Adp of the SNF Oct 1, 2024
Fox Rehab PT Ia PLLC Organization, Cherry Hill, NJ LLC, Consulting firm Adp of the SNF Jun 30, 2024
Individual Adp of the SNF Jun 30, 2024
Nancy Schrupp Individual Operational/Managerial Control Aug 31, 2009
Sharina Winter Individual Operational/Managerial Control Nov 4, 2024
Adp of the SNF Oct 10, 2025
Mari Kroneman Individual Corporate DirectorBoard Member Jan 1, 2023
Fox Rehab OT Ia LLC Organization, Cherry Hill, NJ LLC, Consulting firm Adp of the SNF Jun 30, 2024
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF May 27, 2021
Individual Adp of the SNF Oct 1, 2024
Robert Lamp Individual Operational/Managerial Control Mar 25, 2024
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF Oct 1, 2024
Ecsi Inc Organization, West Des Moines, IA Corporation Adp of the SNF Oct 1, 2024
Peter Julseth Individual Corporate OfficerBoard Vice President Jan 20, 2022
Lynn Davis Individual Corporate OfficerBoard Treasurer Jan 1, 2005
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF May 27, 2021
Timothy Knutson Individual Corporate DirectorBoard Member Jan 20, 2024
Individual Adp of the SNF Jun 29, 2007
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF Jun 29, 2007
Individual Adp of the SNF Jun 29, 2007
Individual Adp of the SNF Oct 1, 2024
Ruth Merchant Individual Operational/Managerial Control May 20, 2025
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF Oct 1, 2024
Kevin Bidne Individual Corporate DirectorBoard Member Jun 1, 2025
Josh Steinberg Individual Corporate DirectorBoard Member Jan 20, 2022
Individual Adp of the SNF Oct 1, 2024
Mercy Health Services- Iowa Corp Organization, Mason City, IA Corporation, Medical provider/supplier Adp of the SNF May 27, 2021
Next Generation Technologies Organization, Buffalo Center, IA Corporation, Consulting firm Adp of the SNF Nov 2, 2022
Individual Adp of the SNF May 27, 2021
Individual Adp of the SNF Oct 1, 2024
Individual Adp of the SNF May 27, 2021
Individual Adp of the SNF Oct 1, 2024
Cassie Davis Individual Operational/Managerial Control Apr 2, 2018
Cattail BCG LLC Organization, Muscatine, IA LLC Adp of the SNF Oct 1, 2024
Brighton Consulting Group LLC Organization, Urbandale, IA LLC, Consulting firm Adp of the SNF Oct 1, 2024

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20030203000031 IA Part a Provider - Skilled Nursing Facility 7911816616 Practice locations: Northwood, IA

National Provider Directory

National Provider Directory

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
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 Registry

Primary 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
IdentifierTypeStateIssuer
0802355MedicaidIA
03173110OtherIAAMERIGROUP
65485OtherIABCBS 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

Verify at the official NPI Registry.