NPIMap

Organization Active NPI

Osceola Community Hospital Inc

Doing business as Osceola Regional Health Center

  • Medicare Defined Swing Bed Hospital Unit
  • Sibley, IA
National Provider Identifier
1861560609
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
OSCEOLA COMMUNITY HOSPITAL INC
Doing business as
Osceola Regional Health Center
Practice address
600 9TH Ave N
Sibley, IA 51249-1012
Phone
(712) 754-2574
Fax
(712) 754-3782
NPI assigned
Dec 1, 2006
Last updated
Jul 17, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
OSCEOLA COMMUNITY HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Andrea R Johnson
Title
Cfo
Phone
(712) 754-5353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X IA Primary

Addresses

Primary practice location

600 9TH Ave N
Sibley, IA 51249-1012

Mailing address

600 9TH Ave N
Sibley, IA 51249-1012

Other identifiers 2

IdentifierTypeStateIssuer
0655217MedicaidIA
66130OtherWELLMARK

Other names 1

  • Osceola Regional Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070109000506 IA Part A Provider - Critical Access Hospital 5799692372 Practice locations: Sibley, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861560609. Details of each certification follow.

Hospital certification: CCN 16Z345

Legal name
OSCEOLA COMMUNITY HOSPITAL INC
Doing business as
OSCEOLA REGIONAL HEALTH CENTER
Organization structure
CorporationNon-profit
Enrollment address
600 9TH Ave N
Sibley, IA 51249-1012
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Osceola Comm Hospital Inc3 organizations share this tax ID, including this one
Part of
Osceola Comm Hospital Inc

Other organizations with this tax ID 2

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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Brian D Mino Individual Corporate OfficerTreasurer Dec 1, 2019
Gloria Torres Individual Corporate OfficerPresident Elect Jan 1, 2025
Brad Alan Jensen Individual Corporate OfficerSecretary Jan 1, 2025
Holly Wilson Individual Corporate DirectorTrustee Nov 1, 2020
Cheryl Peters Individual Corporate DirectorTrustee Jan 1, 2025
Andrea R Johnson Individual Corporate OfficerCfo Sep 19, 2022
W-2 Managing EmployeeCfo Sep 19, 2022
Operational/Managerial ControlCfo Sep 19, 2022
Brandon Krikke Individual Corporate DirectorTrustee Jan 1, 2025
Wilbur Bruce Boer Individual Corporate DirectorTrustee Jan 1, 2025
Amber Bosma Individual Corporate OfficerBoard President Jan 1, 2025
Lorraine Marie Reed Individual Corporate OfficerBusiness Office Manager Jan 1, 2015
W-2 Managing EmployeeBusiness Office Mananger Jan 1, 2015
Abby de Zeeuw Individual Corporate DirectorTrustee Jan 1, 2025
Joseph Heitritter Individual W-2 Managing EmployeeCeo Sep 18, 2023
Operational/Managerial ControlCeo Sep 18, 2023

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1861560609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 9TH AVE N",
            "city": "SIBLEY",
            "state": "IA",
            "postal_code": "512491012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 9TH AVE N",
            "city": "SIBLEY",
            "state": "IA",
            "postal_code": "512491012",
            "telephone_number": "712-754-2574",
            "fax_number": "712-754-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSCEOLA COMMUNITY HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OSCEOLA COMMUNITY HOSPITAL INC",
        "enumeration_date": "2006-12-01",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "712-754-5353"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0655217",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "66130",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Osceola Regional Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sibley, IA

Sources for this page

Verify at the official NPI Registry.