NPIMap

Organization Active NPI

Hegg Memorial Hospital

Doing business as Hegg Memorial Swingbed

  • Medicare Defined Swing Bed Hospital Unit
  • Rock Valley, IA
National Provider Identifier
1598849812
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
840049H Issued in IA
Legal business name
HEGG MEMORIAL HOSPITAL
Doing business as
Hegg Memorial Swingbed
Practice address
1202 21St Ave
Rock Valley, IA 51247-1420
Phone
(712) 476-8000
Fax
(712) 476-8090
NPI assigned
Oct 24, 2006
Last updated
May 7, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
HEGGMEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Authorized official

Name
Glenn Zevenbergen
Title
Ceo
Phone
(712) 476-8001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 840049H IA Primary

Addresses

Primary practice location

1202 21St Ave
Rock Valley, IA 51247-1420

Mailing address

1202 21St Ave
Rock Valley, IA 51247-1420
Phone (712) 476-8000

Other identifiers 2

IdentifierTypeStateIssuer
66145OtherIAWELLMARK
0655068MedicaidIA

Other names 1

  • HEGG MEMORIAL SWINGBED Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070125000393 IA Part A Provider - Critical Access Hospital 5193718757 Practice locations: Rock Valley, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598849812. Details of each certification follow.

Hospital certification: CCN 16Z336

Legal name
HEGG MEMORIAL HOSPITAL
Doing business as
HEGG MEMORIAL HEALTH CENTER
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 1965 in IA
Enrollment address
1202 21St Ave
Rock Valley, IA 51247-1420

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

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Hegg Memorial Health Center4 organizations share this tax ID, including this one
Part of
Hegg Memorial Health Center

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
William Slater Individual Corporate OfficerCfo Nov 9, 2018
Glenn Alan Zevenbergen Individual Contracted Managing EmployeeCeo Dec 20, 2003 100%
Corporate OfficerCeo Dec 20, 2003 100%
Jason Vansurksum Individual Corporate DirectorChairman Jan 1, 2020

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hegg Home Health CareRock Valley, IA, CCN 167236 Home health agency Operational/Managerial Control (100%) Jun 15, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1598849812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 21ST AVE",
            "city": "ROCK VALLEY",
            "state": "IA",
            "postal_code": "512471420",
            "telephone_number": "712-476-8000",
            "fax_number": "712-476-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 21ST AVE",
            "city": "ROCK VALLEY",
            "state": "IA",
            "postal_code": "512471420",
            "telephone_number": "712-476-8000",
            "fax_number": "712-476-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEGG MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEGGMEMORIAL HOSPITAL",
        "enumeration_date": "2006-10-24",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "ZEVENBERGEN",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "712-476-8001"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "IA",
            "license": "840049H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "66145",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0655068",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEGG MEMORIAL SWINGBED",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rock Valley, IA

Sources for this page

Verify at the official NPI Registry.