NPIMap

Organization Active NPI

Wesley Community Services, Inc.

Doing business as WesleyLife Hospice

  • Community Based Hospice Care Agency
  • Johnston, IA
National Provider Identifier
1730380361
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
WESLEY COMMUNITY SERVICES, INC.
Doing business as
WesleyLife Hospice
Practice address
5508 NW 88TH Street
Johnston, IA 50131
Phone
(515) 271-6777
Fax
(515) 284-1996
NPI assigned
May 30, 2007
Last updated
Nov 17, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
WESLEYLIFEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Authorized official

Name
Mrs. Jennifer Ofelt
Title
Executive Director
Phone
(515) 699-3370

Specialties & licenses 1

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

Addresses

Primary practice location

5508 NW 88TH Street
Johnston, IA 50131

Mailing address

5508 NW 88TH Street
Johnston, IA 50131
Phone (515) 271-6777

Other names 1

  • WesleyLife Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070612000778 IA Part A Provider - Hospice 8729002506 Practice locations: Urbandale, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730380361. Details of each certification follow.

Hospice certification: CCN 161587

Legal name
WESLEY COMMUNITY SERVICES INC
Doing business as
WESLEYLIFE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 5, 2007
Last certification
Mar 21, 2022
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 2006 in IA
Enrollment address
4328 114TH St
Urbandale, IA 50322-5408

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Wesleylife HospiceCCN 161587 · All quality measures
Ownership
Non-Profit
Certified
Nov 5, 2007
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D2107572Wesleylife Hospice4328 114TH Street, Urbandale, IA 50322Certificate of waiverJan 14, 2028

National Provider Directory

National Provider Directory
Tax ID family
Wesley Community Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Chad Rasmussen Individual Corporate Director Jun 1, 2007
Daniel W Reneker Individual Corporate Director Jun 1, 2007
Robert William Kretzinger Individual Corporate Officer Jun 1, 2007
Susan Watson Individual Corporate Director Jan 1, 2014
Janet a Simpson Individual Operational/Managerial ControlRegional VP of Network Operations Jan 1, 2016
Roger K. Lagree Individual Corporate Director Jan 1, 2015
Abbey Gilroy Individual Corporate Director Jan 1, 2016
Kirk J Tyler Individual Corporate Director Jun 1, 2007
Joanne Lorence Individual Corporate Director Jun 1, 2007
David B Stout Individual Corporate Director Jun 1, 2007
Wesley Retirement Services Inc Organization, Johnston, IA Non-profit Operational/Managerial Control Jun 1, 2007
Wesleylife Organization, Johnston, IA Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2007 100%
Operational/Managerial Control Sep 1, 2007 60%
Wesley Community Services Inc Organization, Johnston, IA Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2006
Operational/Managerial Control Sep 1, 2007 40%
Robert M. Ruch Individual Corporate DirectorBoard Member Jun 1, 2007
John F. Moenck Individual Corporate Director Jun 1, 2007

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 1

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

FacilityTypeRoleSince
Wesleylife Home HealthUrbandale, IA, CCN 167295 Home health agency Operational/Managerial Control (40%) Sep 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 11

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

Practitioners & affiliated clinicians

Affiliated clinicians 33

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 33

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447718400000",
    "number": "1730380361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5508 NW 88TH STREET",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "50131",
            "telephone_number": "515-271-6777",
            "fax_number": "515-284-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5508 NW 88TH STREET",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "50131",
            "telephone_number": "515-271-6777",
            "fax_number": "515-284-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY COMMUNITY SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESLEYLIFE",
        "enumeration_date": "2007-05-30",
        "last_updated": "2015-11-17",
        "status": "A",
        "authorized_official_last_name": "OFELT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "515-699-3370",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WesleyLife Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnston, IA

Sources for this page

Verify at the official NPI Registry.