Organization Active NPI

The Ambassador Sidney, Inc.

  • Skilled Nursing Facility
  • Sidney, IA
National Provider Identifier
1902811276
Registry record updated Jul 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
360156 Issued in IA
Legal business name
THE AMBASSADOR SIDNEY, INC.
Practice address
115 Main St
Sidney, IA 51652-6069
Phone
(712) 374-2693
Fax
(712) 374-3064
NPI assigned
Jul 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2014

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

Authorized official

Name
Ms. Marcia Schroeder
Title
Chief Executive Officer
Phone
(402) 873-8507

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 360156 IA
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 360156 IA
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 360156 IA
Skilled Nursing Facility 314000000X 360156 IA Primary

Addresses

Primary practice location

115 Main St
Sidney, IA 51652-6069

Mailing address

115 Main St
Sidney, IA 51652-6069
Phone (712) 374-2693

Other identifiers 2

IdentifierTypeStateIssuer
0809640MedicaidIA
165474OtherIAWELLMARK BLUE CROSS & BLUE SHIELD

Other names 1

  • The Ambassador Sidney Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040503000218 IA Part A Provider - Skilled Nursing Facility 9032107867 Practice locations: Sidney, IA

Skilled nursing facility certification: CCN 165474

Legal name
THE AMBASSADOR SIDNEY INC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 11, 2002
Last certification
Mar 20, 2025
Beds
46
Ownership / control type
Corporation
Multi-facility organization
The Ambassador Holding Co.
Organization structure
CorporationProprietary
Enrollment address
115 Main St
Sidney, IA 51652-6069
Nursing home name
THE AMBASSADOR SIDNEY INC
Affiliated entity
AMBASSADOR HEALTH

National Provider Directory

National Provider Directory

Locations

115 Main St
Sidney, IA 51652
Phone (712) 374-2693

Ownership & related parties

All disclosed owners & managing parties 48

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

NameRoleSinceShare
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jan 1, 2015
The Ambassador Group Inc Organization, Nebraska City, NE Corporation, Management services company Operational/Managerial Control Feb 9, 1981 100%
Adp of the SNF Feb 9, 1981
Individual Adp of the SNF Jul 20, 2025
Tyler J Juilfs Individual 5% Or Greater Indirect Ownership Interest Dec 30, 2024 5%
Corporate OfficerTreasurer Jul 1, 2021 5%
Corporate DirectorTreasurer Jul 1, 2021 5%
Adp of the SNF Dec 30, 2024
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jul 20, 2025
Sally Juilfs Individual 5% Or Greater Indirect Ownership InterestSecretary Jun 5, 1985 44%
Corporate OfficerSecretary Jun 5, 1985
Corporate DirectorSecretary Jun 5, 1985
Adp of the SNF Jun 5, 1985
Individual Adp of the SNF Jul 20, 2025
Organization, Omaha, NE Corporation Adp of the SNF Apr 16, 2025
Individual Adp of the SNF Jul 20, 2025
Organization, Seward, NE LLC, Consulting firm Adp of the SNF Aug 7, 2025
Michael J Ourada Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 30, 2025
Individual Adp of the SNF Jul 20, 2025
Ambassador Holding Company Organization, Nebraska City, NE Created for acquisition, Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 5, 1985 100%
Adp of the SNF Jun 5, 1985
Individual Adp of the SNF Jul 20, 2025
Organization, Lincoln, NE Management services company Adp of the SNF Apr 16, 2025
Individual Adp of the SNF Jul 20, 2025
Dora Long Individual Operational/Managerial Control Jul 16, 2021
Individual Adp of the SNF Jul 20, 2025
Organization, Kennett Square, PA LLC, Medical provider/supplier, For-profit Adp of the SNF Apr 16, 2025
First National Bank Omaha Organization, Omaha, NE Financial institution, Owned by another organization or individual 5% Or Greater Mortgage Interest Jan 30, 2018 26%
Adp of the SNF Apr 16, 2025
Organization, Lincoln, NE LLC, For-profit Adp of the SNF Apr 16, 2025
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jul 20, 2025
Brent B Shanholtz Individual Operational/Managerial ControlCfo Jan 1, 2013 100%
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jul 1, 2016
Individual Adp of the SNF Jul 20, 2025
Timothy Juilfs Individual 5% Or Greater Indirect Ownership InterestPresident Jun 5, 1985 44%
Corporate OfficerPresident Jun 5, 1985 50%
Corporate DirectorPresident May 1, 2004 50%
Adp of the SNF Jun 5, 1985
Jade Harrah Individual Operational/Managerial Control Oct 10, 2022
Adp of the SNF Jan 30, 2025
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jul 1, 2021
Individual Adp of the SNF Jul 20, 2025
Organization, Nebraska City, NE Financial institution Adp of the SNF Jul 9, 2025
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jul 20, 2025
Organization, Omaha, NE LLC, Consulting firm Adp of the SNF Apr 16, 2025
Organization, Omaha, NE Medical staffing company Adp of the SNF Aug 7, 2025
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jul 20, 2025
Individual Adp of the SNF Jul 20, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Ambassador Sidney IncCCN 165474
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Nov 11, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4640.8 residents per day on average
Chain
Ambassador Health4 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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
16D0881604Ambassador Sidney, the115 Main Street, Sidney, IA 51652Certificate of waiverJan 11, 2028

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404777600000",
    "number": "1902811276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MAIN ST",
            "city": "SIDNEY",
            "state": "IA",
            "postal_code": "516526069",
            "telephone_number": "712-374-2693",
            "fax_number": "712-374-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MAIN ST",
            "city": "SIDNEY",
            "state": "IA",
            "postal_code": "516526069",
            "telephone_number": "712-374-2693",
            "fax_number": "712-374-3064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE AMBASSADOR SIDNEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2014-07-08",
        "status": "A",
        "authorized_official_last_name": "SCHROEDER",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "402-873-8507",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "360156",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "360156",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "360156",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "360156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0809640",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS & BLUE SHIELD",
            "identifier": "165474",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Ambassador Sidney",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sidney, IA

Sources for this page

Verify at the official NPI Registry.