NPIMap

Organization Active NPI

Palo Alto County Hospital

  • Community Based Hospice Care Agency
  • Emmetsburg, IA
National Provider Identifier
1598869232
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
740045H Issued in IA
Legal business name
PALO ALTO COUNTY HOSPITAL
Practice address
3201 1St St
Emmetsburg, IA 50536-2516
Phone
(712) 852-5500
Fax
(712) 852-5477
NPI assigned
Sep 12, 2006
Organization subpart
Yes
Parent organization
PALO ALTO COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Authorized official

Name
Desiree A Einsweiler
Title
Administrator/Ceo
Phone
(712) 852-5401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 740045H IA Primary

Addresses

Primary practice location

3201 1St St
Emmetsburg, IA 50536-2516

Mailing address

3201 1St St
Emmetsburg, IA 50536-2516
Phone (712) 852-5500

Other identifiers 2

IdentifierTypeStateIssuer
0615302MedicaidIA
61530OtherIABC HOSPICE PROVIDER #

Other names 1

  • Hospice of Palo Alto County Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address HIM@pamhn.cernerdirect.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050325000482 IA Part A Provider - Hospice 4486563061 Practice locations: Emmetsburg, IA

Hospice certification: CCN 161530

Legal name
PALO ALTO COUNTY HOSPITAL
Doing business as
HOSPICE OF PALO ALTO COUNTY
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 7, 1993
Last certification
Sep 23, 2020
Ownership / control type
Government - County
Organization structure
GovernmentNon-profit
Enrollment address
3201 1St St
Emmetsburg, IA 50536-2516

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: Hospice

Medicare Care Compare
Listed as
Hospice of Palo Alto CountyCCN 161530
Ownership
Government
Certified
Sep 7, 1993
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Palo Alto Comm Hospital9 organizations share this tax ID, including this one
Part of
Palo Alto Comm Hospital

Other organizations with this tax ID 8

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

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
Coleen R Ruddy Individual W-2 Managing Employee Jul 1, 2004
Cynthia Magee Individual Corporate Director Jan 23, 2019
Terry Naig Individual Corporate Director Aug 22, 2012
Dawn Schmidt Individual Corporate Director Aug 27, 2008
Sarah Strohman Individual Corporate DirectorAgencydirector Jun 23, 2017 100%
Operational/Managerial ControlAgency Director Jun 23, 2017 100%
Palo Alto County Hospital Organization, Emmetsburg, IA Non-profit Operational/Managerial Control Sep 9, 1993
Collette Johnson Individual Corporate Director Jun 20, 2016
W-2 Managing Employee Jun 20, 2016
Operational/Managerial Control Jun 20, 2016
Melanie Flynn Individual Corporate Director Jan 27, 2021
Richard Brennan Individual Corporate Director Feb 20, 2019
Jana Harris Individual Corporate Director Jan 23, 2019
Jonathan Dean Moe Individual Contracted Managing Employee Feb 1, 2021
Corporate Officer Feb 1, 2021
Operational/Managerial Control Feb 1, 2021
Burt J. Hobart Individual Corporate Director Jan 2, 2008

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Palo Alto County HospitalEmmetsburg, IA, CCN 161357 Hospital Operational/Managerial Control Jan 2, 2013
Palo Alto County HospitalEmmetsburg, IA, CCN 16Z357 Hospital Operational/Managerial Control Jan 2, 2008
Palo Alto Community Health ServicesEmmetsburg, IA, CCN 167049 Home health agency Operational/Managerial Control Jan 10, 2012
Family Practice Clinic West BendWest Bend, IA, CCN 163417 Rural health clinic Operational/Managerial Control Sep 12, 1994

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

Affiliated clinicians 3

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": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1598869232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 1ST ST",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "505362516",
            "telephone_number": "712-852-5500",
            "fax_number": "712-852-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 1ST ST",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "505362516",
            "telephone_number": "712-852-5500",
            "fax_number": "712-852-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALO ALTO COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALO ALTO COUNTY HOSPITAL",
        "enumeration_date": "2006-09-12",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "EINSWEILER",
        "authorized_official_first_name": "DESIREE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "712-852-5401"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IA",
            "license": "740045H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0615302",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC HOSPICE PROVIDER #",
            "identifier": "61530",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "HIM@pamhn.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "PACHS Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3201 1st St",
            "city": "Emmetsburg",
            "state": "IA",
            "country_code": "US",
            "postal_code": "505362516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Hospice of Palo Alto County",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hospice of Palo Alto County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Emmetsburg, IA

Sources for this page

Verify at the official NPI Registry.