NPIMap

Organization Active NPI

Belmond Community Hospital

  • Rural Health Clinic/Center
  • Rockwell, IA
National Provider Identifier
1891483087
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BELMOND COMMUNITY HOSPITAL
Practice address
705 Elm St E
Rockwell, IA 50469-1035
Phone
(641) 372-0315
Fax
(866) 610-4384
NPI assigned
Apr 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Authorized official

Name
Gregory Polzin
Title
Chief Financial Office
Phone
(641) 444-5623

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

705 Elm St E
Rockwell, IA 50469-1035

Mailing address

1316 S Main St
Clarion, IA 50525-2019
Phone (515) 532-2811

Other names 1

  • Rockwell Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230526001648 IA Part A Provider - Rural Health Clinic 1052201852 Practice locations: Rockwell, IA

Rural health clinic certification: CCN 168669

Legal name
BELMOND COMMUNITY HOSPITAL
Doing business as
ROCKWELL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 3, 2024
Last certification
May 3, 2024
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
705 Elm St E
Rockwell, IA 50469-1035
Related CCNs
161301

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

Other NPIs with the same Medicare PAC ID 6

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

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
16D1106491Iowa Specialty Clinic Rockwell705 Elm Street East, Rockwell, IA 50469Certificate of waiverMar 21, 2028

National Provider Directory

National Provider Directory
Tax ID family
Belmond Comm Hospital8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

5901 Thornton Ave
Ste 101
Des Moines, IA 50321
Phone (515) 327-2000

840 W US Highway 18
Garner, IA 50438
Phone (641) 925-1500

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Gregory C Polzin Individual Corporate Director Jul 1, 2014
Teri Havens Individual Corporate Director Feb 5, 2018
Tom Christianson Individual Corporate Director Feb 5, 2018
Brad Robson Individual Corporate Director Jun 1, 2004
Missy Brannick Individual W-2 Managing Employee Feb 5, 2018
City of Belmond Iowa Organization, Belmond, IA Non-profit Operational/Managerial Control Jan 1, 2000 100%
Nancy Ann Gabrielson Individual Corporate Director Jan 1, 2019
Troy Watne Individual Corporate Director Jan 27, 2016
Kelly J Leu Individual W-2 Managing Employee Oct 1, 2012
Amy McDaniel Individual Corporate Officer Nov 1, 2013

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Iowa Specialty Hospital-BelmondBelmond, IA, CCN 161301 Hospital Operational/Managerial Control (100%) Dec 27, 2019
Iowa Specialty Hospital - BelmondBelmond, IA, CCN 16Z301 Hospital Operational/Managerial Control (100%) Jan 1, 2000
Hampton ClinicHampton, IA, CCN 168559 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2000

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 87

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 87

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1891483087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 S MAIN ST",
            "city": "CLARION",
            "state": "IA",
            "postal_code": "505252019",
            "telephone_number": "515-532-2811",
            "fax_number": "319-343-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 ELM ST E",
            "city": "ROCKWELL",
            "state": "IA",
            "postal_code": "504691035",
            "telephone_number": "641-372-0315",
            "fax_number": "866-610-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELMOND COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-26",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "POLZIN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICE",
        "authorized_official_telephone_number": "641-444-5623"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rockwell Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockwell, IA

Sources for this page

Verify at the official NPI Registry.