Belmond Community Hospital
Organization Active NPI Rural Health Clinic/Center · Belmond, IA
NPI 1841536745 · NPPES record last updated Jan 20, 2020
Key facts
- NPI
- 1841536745
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 990169H (IA)
- Legal business name
- BELMOND COMMUNITY HOSPITAL
- Practice address
- 403 1St St SE
Belmond, IA 50421-1201 - Phone
- (641) 444-3500
- Fax
- (641) 444-5554
- NPI assigned
- Dec 20, 2012
- Organization subpart
- No
Authorized official
- Name
- Amy McDaniel
- Title
- Ceo
- Phone
- (641) 444-5621
Owners & managing parties with NPI records 6
Owned or controlled facilities with NPI records 3
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 6
Related certifications (CCN) 1
Practitioners 86
-
Randi Rae Gambell, LISW
-
Kenneth W Adams, D.O.
-
Jon S Ahrendsen, M.D.
-
Carla Louise Aldrich, CRNA
-
Jolene Renee Bahling, ARNP
-
Monique Bailey, ARNP
-
Kaitlen Baker, MD
-
Robert E Berg, MD
-
Jacob Boll, CRNA
-
Amber Lee Campbell, APRN
-
Nicole Faye Dennler, ARNP
-
Lynzy Marie Devary, ARNP
-
Renee Diamond, M.D.
-
Chrysten Rae Dohrmann, ARNP
-
Jayme Dougherty, FNP-C
-
Todd Allen Eibes, M.D.
-
Rachael D Etnier, DO
-
Amy Faga, ARNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA
Rural health clinic certification: CCN 168557
- Legal name
- BELMOND COMMUNITY HOSPITAL
- Doing business as
- BELMOND CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Sep 9, 2013
- Last certification
- Oct 21, 2021
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Enrollment address
- 403 1St St SE
Belmond, IA 50421-1201 - Related CCNs
- 161301
Rural health clinic certification: CCN 168559
- Legal name
- BELMOND COMMUNITY HOSPITAL
- Doing business as
- HAMPTON CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jan 30, 2014
- Last certification
- Sep 9, 2021
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Enrollment address
- 700 2ND St SE
Ste 101
Hampton, IA 50441-2658 - Related CCNs
- 161301
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Anna Buseman |
Corporate Director | Jan 1, 2024 | |
| Gregory C Polzin |
Corporate Director | Feb 5, 2018 | |
| Corporate Director | Jul 1, 2014 | ||
| Teri Havens |
Corporate Director | Feb 5, 2018 | |
| Brad Robson |
Corporate Director | Jun 1, 2004 | |
| Missy Brannick |
W-2 Managing Employee | Feb 5, 2018 | |
| Nancy Ann Gabrielson |
Corporate Director | Mar 7, 2019 | |
| Troy Watne |
Corporate Director | Jan 27, 2016 | |
| Kelly J Leu |
W-2 Managing Employee | Feb 28, 2018 | |
| W-2 Managing Employee | Oct 1, 2012 | ||
| Amy McDaniel |
Corporate Officer |
Jul 1, 2012 | |
| Corporate Officer |
Nov 1, 2013 | ||
| Belmond Community Hospital |
Operational/Managerial Control | Jan 1, 2000 | 100% |
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Iowa Specialty Hospital-Belmond |
Hospital | Operational/Managerial Control (100%) | Dec 27, 2019 |
| Iowa Specialty Hospital - Belmond |
Hospital | Operational/Managerial Control (100%) | Jan 1, 2000 |
| Hampton Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Jan 1, 2000 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121221000302 | IA | Part a Provider - Rural Health Clinic | 1052201852 | Practice locations: Belmond, IA |
| O20130426000161 | IA | Part a Provider - Rural Health Clinic | 1052201852 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hampton, IA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | 990169H | IA | Yes |
Addresses
Primary practice location
403 1St St SE
Belmond, IA 50421-1201
Mailing address
403 1St St SE
Belmond, IA 50421-1201
Phone (641) 444-3500
Other names
- Belmond Clinic
Other providers in Belmond, IA
- Valerie Lynn Ball
- Belmond Community Hospital
- Belmond Community Hospital
- Belmond Community Hospital
- Belmond Community Hospital
- Belmond Community Hospital
- Belmond Ia Skilled Nursing Facility, LLC
- Belmond Ia Skilled Nursing Facility, LLC
- Belmond Ia Skilled Nursing Facility, LLC
- Belmond-Klemme Community School District
All providers in Belmond, IA · Rural Health Clinic/Center in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.