NPIMap

Organization Active NPI

Palo Alto County Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Emmetsburg, IA
National Provider Identifier
1720099831
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
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) 852-5508
NPI assigned
Aug 11, 2006
Last updated
Dec 3, 2020By the provider in NPPES
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
Phone
(712) 852-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 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
66118OtherIABLUECROSS SKILLED PROV.#
0655027MedicaidIA

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
O20070126000397 IA Part A Provider - Critical Access Hospital 4486563061 Practice locations: Emmetsburg, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720099831. Details of each certification follow.

Hospital certification: CCN 16Z357

Legal name
PALO ALTO COUNTY HOSPITAL
Organization structure
GovernmentNon-profit
Enrollment address
3201 1St St
Emmetsburg, IA 50536-2516
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Palo Alto County Hospit9 organizations share this tax ID, including this one
Part of
Palo Alto County Hospit

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 11

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 Feb 21, 2005
Cynthia Magee Individual Corporate Director Jan 23, 2019
Nick Steinkamp Individual Corporate Director Jun 22, 2022
Mark Hobart Individual Corporate Director Jan 2, 2023
Mikel Jones Individual Corporate Director Jan 2, 2023
Palo Alto County Hospital Organization, Emmetsburg, IA Operational/Managerial Control Jan 2, 2008
Collette Johnson Individual Corporate Director Jun 20, 2016
W-2 Managing Employee Jun 20, 2016
Operational/Managerial Control Jun 20, 2016
Mary Cooper Individual Corporate Director Jan 2, 2023
Melanie Flynn Individual Corporate Director Jan 27, 2021
Richard Brennan Individual Corporate Director Feb 20, 2019
Jonathan Dean Moe Individual Contracted Managing EmployeeCeo Feb 1, 2021
Corporate OfficerCeo Feb 1, 2021
Operational/Managerial ControlCeo Feb 1, 2021

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 Community Health ServicesEmmetsburg, IA, CCN 167049 Home health agency Operational/Managerial Control Jan 10, 2012
Hospice of Palo Alto CountyEmmetsburg, IA, CCN 161530 Hospice Operational/Managerial Control Sep 9, 1993
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

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": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1720099831",
    "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": "712-852-5508"
        },
        {
            "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": "712-852-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALO ALTO COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALO ALTO COUNTY HOSPITAL",
        "enumeration_date": "2006-08-11",
        "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",
        "authorized_official_telephone_number": "712-852-5500"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "IA",
            "license": "740045H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS SKILLED PROV.#",
            "identifier": "66118",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0655027",
            "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": []
}

Other providers in Emmetsburg, IA

Sources for this page

Verify at the official NPI Registry.