Active NPI
County of Jefferson
- Community Based Hospice Care Agency
- Oskaloosa, KS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- Z044001
- Legal business name
- COUNTY OF JEFFERSON
- Practice address
- 1212 Walnut St
Oskaloosa, KS 66066-4200 - Phone
- (785) 863-2447
- Fax
- (785) 863-3323
- NPI assigned
- Jul 11, 2005
- Last updated
- Jun 17, 2011
- 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
- Jeanne Marie Czoch, RN, BSN
- Title
- Home Care Director
- Phone
- (785) 863-2447
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Z044001 | KS | Primary |
Addresses
Primary practice location
1212 Walnut St
Oskaloosa, KS 66066-4200
Mailing address
1212 Walnut St
Oskaloosa, KS 66066-4200
Phone (785) 863-2447
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00818 | Other | KS | BCBS |
| 100089340E | Medicaid | KS |
Other names 1
- Hospice of Jefferson County
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071107000454 | KS | Part A Provider - Hospice | 5496735656 | Practice locations: Oskaloosa, KS |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1730187113. Details of each certification follow.
Hospice certification: CCN 171520
- Legal name
- COUNTY OF JEFFERSON
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Apr 23, 1993
- Last certification
- Mar 29, 2018
- Ownership / control type
- Government - County
- Organization structure
- Government
- Enrollment address
- 1212 Walnut St
Oskaloosa, KS 66066-4200
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Jefferson County Ambulance Service
- Ambulance
- Oskaloosa, KS
- NPI 1245321405
5496735656
Care Compare: Hospice
Medicare Care Compare- Listed as
- Hospice of Jefferson County
- Ownership
- Government
- Certified
- Apr 23, 1993
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- County of Jefferson
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Public Health or Welfare Agency
- Oskaloosa, KS
- NPI 1023016490
-
- Home Health Agency
- Oskaloosa, KS
- NPI 1417955964
Locations
1212 Walnut St
Oskaloosa, KS 66066
Phone (785) 863-2447
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Wanda Agnew | W-2 Managing Employee | May 1, 2026 | 100% |
| County of Jefferson | 5% Or Greater Direct Ownership Interest | Apr 23, 1993 | |
| Operational/Managerial Control | Apr 23, 1993 |
Owners & managing parties with NPI records 3
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Public Health or Welfare Agency
- Oskaloosa, KS
- NPI 1023016490
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Jefferson County Ambulance Service
- Ambulance
- Oskaloosa, KS
- NPI 1245321405
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
- Home Health Agency
- Oskaloosa, KS
- NPI 1417955964
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| County of Jefferson | Home health agency | Operational/Managerial Control (100%) | Oct 1, 2007 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
Practitioners & affiliated clinicians
Affiliated clinicians 2
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": "1121040000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1308268800000",
"number": "1730187113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 WALNUT ST",
"city": "OSKALOOSA",
"state": "KS",
"postal_code": "660664200",
"telephone_number": "785-863-2447",
"fax_number": "785-863-3323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 WALNUT ST",
"city": "OSKALOOSA",
"state": "KS",
"postal_code": "660664200",
"telephone_number": "785-863-2447",
"fax_number": "785-863-3323"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTY OF JEFFERSON",
"organizational_subpart": "NO",
"enumeration_date": "2005-07-11",
"last_updated": "2011-06-17",
"status": "A",
"authorized_official_last_name": "CZOCH",
"authorized_official_first_name": "JEANNE",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "HOME CARE DIRECTOR",
"authorized_official_telephone_number": "785-863-2447",
"authorized_official_credential": "RN, BSN"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "KS",
"license": "Z044001",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "00818",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100089340E",
"state": "KS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hospice of Jefferson County",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Oskaloosa, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.