Active NPI
St Croix Hospice LLC
- Community Based Hospice Care Agency
- Council Bluffs, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- ST CROIX HOSPICE LLC
- Practice address
- 1920 Rue St Ste 3
Council Bluffs, IA 51503-3601 - Phone
- (712) 318-2120
- Fax
- (712) 396-2008
- NPI assigned
- Aug 7, 2012
- 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
- Stephen Phenneger
- Title
- Cfo and President
- Phone
- (612) 544-6133
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
1920 Rue St Ste 3
Council Bluffs, IA 51503-3601
Mailing address
1175 Centre Pointe Cir
Mendota Heights, MN 55120-5500
Phone (651) 735-3656
Other names 1
- St. Croix Hospice
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150803000182 | IA | Part A Provider - Hospice | 2264596121 | Practice locations: Council Bluffs, IA; Denison, IA; Clarinda, IA |
Hospice certification: CCN 161602
- Legal name
- ST CROIX HOSPICE LLC
- Doing business as
- ST CROIX HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Feb 5, 2013
- Last certification
- Nov 11, 2021
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC
- Incorporated
- Jan 23, 2012 in MN
- Enrollment address
- 1920 Rue St
Ste 3
Council Bluffs, IA 51503-3601
Other NPIs with the same Medicare PAC ID 12
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Community Based Hospice Care Agency
- Strawberry Point, IA
- NPI 1689090326
2264596121
Care Compare: Hospice
Medicare Care Compare- Listed as
- St Croix Hospice
- Ownership
- For-Profit
- Certified
- Feb 5, 2013
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D2045473 | St Croix Hospice - Council Bluffs | Certificate of waiver | Aug 13, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- St Croix Hospice LLC
Other organizations with this tax ID 13
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community Based Hospice Care Agency
- Charles City, IA
- NPI 1093128431
-
- Community Based Hospice Care Agency
- Ankeny, IA
- NPI 1114273828
-
- Community Based Hospice Care Agency
- Spirit Lake, IA
- NPI 1659786259
-
- Community Based Hospice Care Agency
- Strawberry Point, IA
- NPI 1689090326
-
- Community Based Hospice Care Agency
- Maple Grove, MN
- NPI 1376127548
-
- Community Based Hospice Care Agency
- Albert Lea, MN
- NPI 1437721750
-
- Community Based Hospice Care Agency
- Sioux Falls, SD
- NPI 1437733094
-
- Community Based Hospice Care Agency
- Oakdale, MN
- NPI 1508018185
-
- Community Based Hospice Care Agency
- Omaha, NE
- NPI 1740553940
-
- Community Based Hospice Care Agency
- Grand Rapids, MN
- NPI 1770142762
-
- Community Based Hospice Care Agency
- Eau Claire, WI
- NPI 1841601952
-
- Community Based Hospice Care Agency
- Topeka, KS
- NPI 1922438118
Locations
1920 Rue St
Ste 3
Council Bluffs, IA 51503
Phone (712) 318-2120
Ownership & related parties
All disclosed owners & managing parties 25
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 |
|---|---|---|---|
| Melissa a Andrews | Contracted Managing Employee | Oct 24, 2025 | |
| Operational/Managerial Control | Oct 24, 2025 | ||
| Qsuper Global Private Equity TR | 5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 5.04% |
| Antares Capital LP | 5% Or Greater Security Interest | Oct 30, 2020 | 100% |
| Clayton Joseph Hoberman | W-2 Managing Employee | May 1, 2018 | |
| Operational/Managerial Control | May 1, 2018 | ||
| Andrew Graham Mayo | W-2 Managing Employee | Sep 29, 2014 | |
| Operational/Managerial Control | Sep 29, 2014 | ||
| Stephen C Phenneger | Corporate Officer | Oct 29, 2020 | |
| Corporate Director | Oct 29, 2020 | ||
| W-2 Managing Employee | Oct 29, 2020 | ||
| Operational/Managerial Control | Oct 29, 2020 | ||
| The State Public Sector | 5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 5.04% |
| TVG-STC Intermediate Corp | 5% Or Greater Indirect Ownership Interest | Sep 29, 2017 | 100% |
| STCH Acquisition Inc | 5% Or Greater Indirect Ownership Interest | Oct 30, 2020 | 100% |
| STCH Intermediate Inc | 5% Or Greater Indirect Ownership Interest | Oct 30, 2020 | 100% |
| Mandy L Cogswell | W-2 Managing Employee | Oct 1, 2017 | |
| Operational/Managerial Control | Oct 1, 2017 | ||
| Hig STCH II LP | 5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 13.71% |
| SCHP Holdings LP | 5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 100% |
| SCHP Topco Inc | 5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 100% |
| Partners Group Access PF 882 LP | 5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 60.09% |
| St Croix Hospice Acquisition Corp | 5% Or Greater Direct Ownership Interest | Oct 1, 2013 | 100% |
| STCH Parent Inc | 5% Or Greater Indirect Ownership Interest | Oct 30, 2020 | 100% |
| Heath a Bartness | Corporate Officer | Feb 28, 2013 | |
| Corporate Director | Feb 28, 2013 | ||
| W-2 Managing Employee | Feb 28, 2013 | ||
| Operational/Managerial Control | Feb 28, 2013 | ||
| SCHP Midco Inc | 5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 100% |
| Partners Group Daintree Credit Co-Invest LP | 5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 5.04% |
| SCHP Intermediate Inc | 5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 100% |
| Partners Group Direct Equity V Eur | 5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 5.9% |
| Tracee L Gettys | W-2 Managing Employee | Dec 30, 2025 | |
| Operational/Managerial Control | Dec 30, 2025 | ||
| SCHP Purchaser Inc | 5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 100% |
| Partners Group Global Value Sicav | 5% Or Greater Indirect Ownership Interest | Oct 24, 2025 | 9.3% |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
- Omaha, NE
- NPI 1073615209
Operational/Managerial Control, W-2 Managing Employee
-
- Family Medicine Physician
- Omaha, NE
- NPI 1316059660
Operational/Managerial Control, W-2 Managing Employee
All facility ownership & control disclosures 24
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| St Croix Hospice Lombard | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Apr 1, 2022 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Feb 9, 2024 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Feb 9, 2024 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Jan 18, 2024 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Jul 18, 2024 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Aug 1, 2022 |
| St Croix Hospice Des Plaines | Hospice | Operational/Managerial Control | Jul 1, 2021 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Jan 18, 2024 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Feb 9, 2024 |
| St. Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Aug 1, 2022 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Aug 1, 2022 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Feb 9, 2024 |
| St Croix Hospice Plymouth | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Apr 29, 2022 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Jul 15, 2022 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Apr 5, 2023 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Apr 5, 2023 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Apr 5, 2023 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Feb 28, 2024 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Dec 23, 2024 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Oct 28, 2024 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | May 22, 2024 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Feb 28, 2024 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Jul 29, 2025 |
| St Croix Hospice | Hospice | 5% Or Greater Indirect Ownership Interest (100%) | Jul 29, 2025 |
Owned or controlled facilities with NPI records 24
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Community Based Hospice Care Agency
- Indianapolis, IN
- NPI 1770180168
5% Or Greater Indirect Ownership Interest
-
- Community Based Hospice Care Agency
- Newburgh, IN
- NPI 1982299558
5% Or Greater Indirect Ownership Interest
-
- Community Based Hospice Care Agency
- Jeffersonville, IN
- NPI 1093260697
5% Or Greater Indirect Ownership Interest
-
- Community Based Hospice Care Agency
- Troy, MI
- NPI 1578830881
5% Or Greater Indirect Ownership Interest
-
- Community Based Hospice Care Agency
- Livonia, MI
- NPI 1689304685
5% Or Greater Indirect Ownership Interest
-
- Community Based Hospice Care Agency
- Rockford, IL
- NPI 1659301539
5% Or Greater Indirect Ownership Interest
-
- Community Based Hospice Care Agency
- Waukesha, WI
- NPI 1508209438
5% Or Greater Indirect Ownership Interest
-
- Community Based Hospice Care Agency
- Lombard, IL
- NPI 1679660153
5% Or Greater Indirect Ownership Interest
-
- Community Based Hospice Care Agency
- Saint Peters, MO
- NPI 1871672493
5% Or Greater Indirect Ownership Interest
-
- Community Based Hospice Care Agency
- Bolivar, MO
- NPI 1174699003
5% Or Greater Indirect Ownership Interest
-
- Community Based Hospice Care Agency
- Harrisonville, MO
- NPI 1730464033
5% Or Greater Indirect Ownership Interest
-
- Community Based Hospice Care Agency
- Palos Heights, IL
- NPI 1285151449
Operational/Managerial Control
Facilities with the same owner 36
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Community Based Hospice Care Agency
- Charles City, IA
- NPI 1093128431
Hig STCH II LP, Partners Group Access PF 882 LP, Partners Group Daintree Credit Co-Invest LP, Partners Group Direct Equity V Eur, Partners Group Global Value Sicav, Qsuper Global Private Equity TR, SCHP Holdings LP, SCHP Intermediate Inc, SCHP Mid
-
- Community Based Hospice Care Agency
- Ankeny, IA
- NPI 1114273828
Hig STCH II LP, Partners Group Access PF 882 LP, Partners Group Daintree Credit Co-Invest LP, Partners Group Direct Equity V Eur, Partners Group Global Value Sicav, Qsuper Global Private Equity TR, SCHP Holdings LP, SCHP Intermediate Inc, SCHP Mid
-
- Community Based Hospice Care Agency
- Spirit Lake, IA
- NPI 1659786259
Hig STCH II LP, Partners Group Access PF 882 LP, Partners Group Daintree Credit Co-Invest LP, Partners Group Direct Equity V Eur, Partners Group Global Value Sicav, Qsuper Global Private Equity TR, SCHP Holdings LP, SCHP Intermediate Inc, SCHP Mid
-
- Community Based Hospice Care Agency
- Strawberry Point, IA
- NPI 1689090326
Hig STCH II LP, Partners Group Access PF 882 LP, Partners Group Daintree Credit Co-Invest LP, Partners Group Direct Equity V Eur, Partners Group Global Value Sicav, Qsuper Global Private Equity TR, SCHP Holdings LP, SCHP Intermediate Inc, SCHP Mid
-
- Community Based Hospice Care Agency
- Indianapolis, IN
- NPI 1770180168
Hig STCH II LP, Partners Group Access PF 882 LP, Partners Group Daintree Credit Co-Invest LP, Partners Group Direct Equity V Eur, Partners Group Global Value Sicav, Qsuper Global Private Equity TR, SCHP Holdings LP, SCHP Intermediate Inc, SCHP Mid
-
- Community Based Hospice Care Agency
- Newburgh, IN
- NPI 1982299558
Hig STCH II LP, Partners Group Access PF 882 LP, Partners Group Daintree Credit Co-Invest LP, Partners Group Direct Equity V Eur, Partners Group Global Value Sicav, Qsuper Global Private Equity TR, SCHP Holdings LP, SCHP Intermediate Inc, SCHP Mid
-
- Community Based Hospice Care Agency
- Jeffersonville, IN
- NPI 1093260697
Hig STCH II LP, Partners Group Access PF 882 LP, Partners Group Daintree Credit Co-Invest LP, Partners Group Direct Equity V Eur, Partners Group Global Value Sicav, Qsuper Global Private Equity TR, SCHP Holdings LP, SCHP Intermediate Inc, SCHP Mid
-
- Community Based Hospice Care Agency
- Troy, MI
- NPI 1578830881
Hig STCH II LP, Partners Group Access PF 882 LP, Partners Group Daintree Credit Co-Invest LP, Partners Group Direct Equity V Eur, Partners Group Global Value Sicav, Qsuper Global Private Equity TR, SCHP Holdings LP, SCHP Intermediate Inc, SCHP Mid
-
- Community Based Hospice Care Agency
- Livonia, MI
- NPI 1689304685
Hig STCH II LP, Partners Group Access PF 882 LP, Partners Group Daintree Credit Co-Invest LP, Partners Group Direct Equity V Eur, Partners Group Global Value Sicav, Qsuper Global Private Equity TR, SCHP Holdings LP, SCHP Intermediate Inc, SCHP Mid
-
- Community Based Hospice Care Agency
- Rockford, IL
- NPI 1659301539
Hig STCH II LP, SCHP Holdings LP, SCHP Intermediate Inc, SCHP Midco Inc, SCHP Purchaser Inc, SCHP Topco Inc, St Croix Hospice Acquisition Corp, STCH Acquisition Inc, STCH Intermediate Inc, STCH Parent Inc, TVG-STC Intermediate Corp
-
- Community Based Hospice Care Agency
- Waukesha, WI
- NPI 1508209438
Hig STCH II LP, Partners Group Access PF 882 LP, Partners Group Daintree Credit Co-Invest LP, Partners Group Direct Equity V Eur, Partners Group Global Value Sicav, Qsuper Global Private Equity TR, SCHP Holdings LP, SCHP Intermediate Inc, SCHP Mid
-
- Community Based Hospice Care Agency
- Lombard, IL
- NPI 1679660153
Hig STCH II LP, Partners Group Access PF 882 LP, Partners Group Daintree Credit Co-Invest LP, Partners Group Direct Equity V Eur, Partners Group Global Value Sicav, Qsuper Global Private Equity TR, SCHP Holdings LP, SCHP Intermediate Inc, SCHP Mid
Practitioners & affiliated clinicians
Affiliated clinicians 14
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": "1344297600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1779321600000",
"number": "1871840975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1175 CENTRE POINTE CIR",
"city": "MENDOTA HEIGHTS",
"state": "MN",
"postal_code": "551205500",
"telephone_number": "651-735-3656",
"fax_number": "651-735-0155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 RUE ST STE 3",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515033601",
"telephone_number": "712-318-2120",
"fax_number": "712-396-2008"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST CROIX HOSPICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-08-07",
"last_updated": "2026-05-21",
"certification_date": "2026-05-21",
"status": "A",
"authorized_official_last_name": "PHENNEGER",
"authorized_official_first_name": "STEPHEN",
"authorized_official_title_or_position": "CFO AND PRESIDENT",
"authorized_official_telephone_number": "612-544-6133"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "St. Croix Hospice",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.