Active NPI
On With Life Extended Services, LTD.
Doing business as On With Life Long Term Care
- Pediatric Skilled Nursing Facility
- Polk City, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Skilled Nursing Facility
- License
- 650726
- Legal business name
- ON WITH LIFE EXTENDED SERVICES, LTD.
- Doing business as
- On With Life Long Term Care
- Practice address
- 1002 W Washington Ave
Polk City, IA 50226-2132 - Phone
- (515) 289-9600
- NPI assigned
- Dec 22, 2006
- Last updated
- Jul 17, 2024
- 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
- Erin Luft-Wiskus
- Title
- Credentialing Coordinator
- Phone
- (515) 289-9703
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Skilled Nursing Facility | 3140N1450X | 650726 | IA | Primary |
Addresses
Primary practice location
1002 W Washington Ave
Polk City, IA 50226-2132
Mailing address
715 SW Ankeny Rd
Ankeny, IA 50023-9798
Phone (515) 965-1339
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 599-00 | Medicaid | IA | |
| 65281 | Other | IA | BLUE CROSS BLUE SHIELD |
| 0652818 | Medicaid | IA |
Other names 1
- ON WITH LIFE LONG TERM CARE
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111018000814 | IA | Part A Provider - Skilled Nursing Facility | 0244402188 | Practice locations: Polk City, IA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1841355575. Details of each certification follow.
Skilled nursing facility certification: CCN 165281
- Legal name
- ON WITH LIFE EXTENDED SERVICES LTD
- Doing business as
- ON WITH LIFE LONG TERM CARE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 3, 1996
- Last certification
- Dec 12, 2024
- Beds
- 40
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- On With Life, Inc.
- Organization structure
- Corporation
- Enrollment address
- 1002 W Washington Ave
Polk City, IA 50226-2132 - Nursing home name
- ON WITH LIFE LONG TERM CARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- On With Life Long Term Care
- Overall star rating
- Health inspections
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jul 3, 1996
- Medicare certification status
- Active
- Certified beds
- 40
National Provider Directory
National Provider Directory- Tax ID family
- On With Life Extended Services LTD
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba On With Life Long Term Care
- Pediatric Skilled Nursing Facility
- Polk City, IA
- NPI 1124875091
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba On With Life Outpatient Neuro Rehabilitation - Coralville
- Physical Therapist
- Coralville, IA
- NPI 1255993655
Member Of
Ownership & related parties
All disclosed owners & managing parties 9
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 |
|---|---|---|---|
| On With Life Extended Services LTD | Operational/Managerial Control | Jul 1, 2011 | 100% |
| John Snyder | Managing Control - Governing Body | Jan 1, 2024 | |
| Jeanette a Shelton | Corporate Officer | Nov 1, 2017 | 100% |
| Operational/Managerial Control | Nov 1, 2017 | 100% | |
| Jennifer Lewis | Operational/Managerial Control | Jun 1, 2019 | 100% |
| On With Life Inc | Operational/Managerial Control | Jul 1, 2001 | |
| Jim Foreman | W-2 Managing Employee | Jan 1, 2015 | 100% |
| Diana E Hoogestraat | Managing Control - Governing Body | Jan 1, 2024 | |
| Indirect Ownership Interest | Jan 1, 2024 | ||
| Rudy Fors | Managing Control - Governing Body | Jan 1, 2024 | |
| Indirect Ownership Interest | Jan 1, 2024 | ||
| Kate Benson Larson | Managing Control - Governing Body | Jan 1, 2024 |
Owners & managing parties with NPI records 4
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Clinical Social Worker
- Council Bluffs, IA
- NPI 1508184581
Indirect Ownership Interest, Managing Control - Governing Body
-
dba On With Life at Ankeny
- Skilled Nursing Facility
- Ankeny, IA
- NPI 1043375769
Operational/Managerial Control
-
dba On With Life Outpatient Neuro Rehabilitation - Coralville
- Physical Therapist
- Coralville, IA
- NPI 1255993655
Operational/Managerial Control
-
dba On With
- Clinical Neuropsychologist
- Ankeny, IA
- NPI 1336633346
Operational/Managerial Control
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba On With Life at Ankeny
- Skilled Nursing Facility
- Ankeny, IA
- NPI 1043375769
On With Life Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1721174400000",
"number": "1841355575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 SW ANKENY RD",
"city": "ANKENY",
"state": "IA",
"postal_code": "500239798",
"telephone_number": "515-965-1339",
"fax_number": "515-965-1186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 W WASHINGTON AVE",
"city": "POLK CITY",
"state": "IA",
"postal_code": "502262132",
"telephone_number": "515-289-9600"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ON WITH LIFE EXTENDED SERVICES, LTD.",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-22",
"last_updated": "2024-07-17",
"certification_date": "2024-07-17",
"status": "A",
"authorized_official_last_name": "LUFT-WISKUS",
"authorized_official_first_name": "ERIN",
"authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
"authorized_official_telephone_number": "515-289-9703"
},
"taxonomies": [
{
"code": "3140N1450X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
"state": "IA",
"license": "650726",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "599-00",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "65281",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0652818",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ON WITH LIFE LONG TERM CARE",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Polk City, IA
- Melinda McKinney, DC
- McRock Inc (Polk City Pharmacy)
- Makena Morrison
- Norgaard and Williams General Parternership
- On With Life Extended Services, LTD. (On With Life Long Term Care)
- Ahmed Onwona-Agyeman
- Rhoderline Onwona-Agyeman
- Pharmacy Support Services
- Pinnacle Health Facilities Xvii LP (Polk City Nursing and Rehabilitation Center)
- Polk City Eyecare Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.