NPIMap

Organization Active NPI

Lee County Auditor

Doing business as Lee County Health Department

  • Community Based Hospice Care Agency
  • Fort Madison, IA
National Provider Identifier
1639190259
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LEE COUNTY AUDITOR
Doing business as
Lee County Health Department
Practice address
3 John Bennett Drive
Fort Madison, IA 52627-4036
Phone
(319) 372-5225
Fax
(319) 372-4374
NPI assigned
Jul 21, 2006
Last updated
Dec 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Authorized official

Name
Michele D Ross
Title
Administrator
Phone
(319) 372-5225

Specialties & licenses 1

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

Addresses

Primary practice location

3 John Bennett Drive
Fort Madison, IA 52627-4036

Mailing address

PO Box 1426
Fort Madison, IA 52627-4036
Phone (319) 372-5225

Other identifiers 2

IdentifierTypeStateIssuer
61517OtherIAWELLMARK HOSPICE
0615179MedicaidIA

Other names 1

  • Lee County Health Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050228001000 IA Part A Provider - Hospice 7113970310 Practice locations: Fort Madison, IA; Hamilton, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639190259. Details of each certification follow.

Hospice certification: CCN 161517

Legal name
LEE COUNTY AUDITOR
Doing business as
LEE COUNTY HEALTH DEPARTMENT
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 15, 1990
Last certification
Apr 21, 2022
Ownership / control type
Government - County
Organization structure
GovernmentNon-profit
Enrollment address
5001 Avenue O
Fort Madison, IA 52627-9676

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Lee County Health DepartmentCCN 161517 · All quality measures
Ownership
Government
Certified
Oct 15, 1990
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Lee County Auditor6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
David C Wenger Keller Individual Operational/Managerial ControlHospice Medical Director Aug 6, 2009
Michele D Ross Individual W-2 Managing EmployeeAdministrator Oct 1, 2018

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Lee County Health DepartmentFort Madison, IA, CCN 167055 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jan 3, 1973

Owned or controlled facilities with NPI records 1

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

  • Lee County Auditor

    dba Lee County Health Department

    • Home Health Agency
    • Fort Madison, IA
    • NPI 1437133998

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1639190259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1426",
            "city": "FORT MADISON",
            "state": "IA",
            "postal_code": "526274036",
            "telephone_number": "319-372-5225",
            "fax_number": "319-372-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 JOHN BENNETT DRIVE",
            "city": "FORT MADISON",
            "state": "IA",
            "postal_code": "526274036",
            "telephone_number": "319-372-5225",
            "fax_number": "319-372-4374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE COUNTY AUDITOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "319-372-5225"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK HOSPICE",
            "identifier": "61517",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0615179",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lee County Health Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lee County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Madison, IA

Sources for this page

Verify at the official NPI Registry.