Active NPI
Greenbelt Home Care
- Home Health Agency
- Eldora, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- GREENBELT HOME CARE
- Practice address
- 1506 Edgington Ave
Eldora, IA 50627-1624 - Phone
- (641) 939-8444
- NPI assigned
- Aug 23, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sheryl Kennedy, R.N., B.S.
- Title
- Administrator
- Phone
- (641) 939-8444
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
1506 Edgington Ave
Eldora, IA 50627-1624
Mailing address
1506 Edgington Ave
Eldora, IA 50627-1624
Phone (641) 939-8444
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 67056 | Other | IA | BLUE CROSS BLUE SHIELD |
| 0670869 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030306000006 | IA | Part A Provider - Home Health Agency | 3971412313 | Practice locations: Eldora, IA |
Home health agency certification: CCN 167056A
- Legal name
- GREENBELT HOME CARE
- Doing business as
- HARDIN COUNTY PUBLIC HEALTH
- Organization structure
- Corporation
- Incorporated
- Aug 12, 1998 in IA
- Enrollment address
- 1707 21St St
Eldora, IA 50627-1513
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Greenbelt Home Care
- Overall star rating
- Ownership
- Non-Profit
- Certified
- Feb 1, 1973
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address. The facility is not in the current Medicare enrollment files, which can mean its Medicare enrollment has ended (or, for VA and military hospitals, that it does not enroll).
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 |
|---|---|---|---|
| 16D0384594 | Greenbelt Home Care | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Greenbelt Home Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Public Health or Welfare Agency
- Eldora, IA
- NPI 1063837383
Member of 2
Organizations this organization is a member of, according to the National Provider Directory.
Locations
1707 21st St
Eldora, IA 50627
Phone (641) 939-8444
1506 Edgington Ave
Eldora, IA 50627
Phone (641) 939-7777
Ownership & related parties
All disclosed owners & managing parties 5
As 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 |
|---|---|---|---|
| Tom Borer | Corporate Officer | Jan 1, 2023 | |
| Corporate Director | Jan 1, 2023 | ||
| Dave Dunn | Corporate Officer | Apr 13, 2020 | |
| Corporate Director | Apr 13, 2020 | ||
| William Hoffman | Corporate Director | Apr 13, 2020 | |
| Megan Marie Harrell | Corporate Officer | Dec 28, 2019 | |
| W-2 Managing Employee | Jan 16, 2019 | ||
| Hardin County | 5% Or Greater Direct Ownership Interest | Feb 18, 2020 | 99% |
Practitioners & affiliated clinicians
Affiliated clinicians 6
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": "1124755200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1699768960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1506 EDGINGTON AVE",
"city": "ELDORA",
"state": "IA",
"postal_code": "506271624",
"telephone_number": "641-939-8444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1506 EDGINGTON AVE",
"city": "ELDORA",
"state": "IA",
"postal_code": "506271624",
"telephone_number": "641-939-8444"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREENBELT HOME CARE",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-23",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KENNEDY",
"authorized_official_first_name": "SHERYL",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "641-939-8444",
"authorized_official_credential": "R.N., B.S."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "67056",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0670869",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eldora, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.