Cedar County
Organization Active NPI Home Health Agency · Tipton, IA
NPI 1912939620 · NPPES record last updated Mar 18, 2020
Key facts
- NPI
- 1912939620
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- CEDAR COUNTY
- Practice address
- 400 Cedar St
Tipton, IA 52772-1748 - Phone
- (563) 886-2226
- Fax
- (563) 886-1218
- NPI assigned
- Jul 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Bonnie J Butler, BA
- Title
- Interim Director
- Phone
- (563) 886-2226
Corporate family (same tax ID) 3
Practitioners 1
Medicare Care Compare: Home health agency
- Listed as
- Cedar County Public Health Nursing Services
- Ownership
- Non-Profit
- Certified
- Apr 28, 1970
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Home health agency certification: CCN 167041
- Legal name
- CEDAR COUNTY
- Doing business as
- CEDAR COUNTY PUBLIC HEALTH NURSING SERVICE
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 28, 1970
- Last certification
- Oct 15, 2020
- Ownership / control type
- Non-Profit
- Organization structure
- Government · Non-profit
- Enrollment address
- 400 Cedar St
B-1
Tipton, IA 52772-1750
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Ashley N Hansen |
W-2 Managing Employee |
Aug 1, 2019 | |
| Joselyn Snook |
W-2 Managing Employee | Mar 21, 2022 | |
| Cedar County |
5% Or Greater Direct Ownership Interest | Sep 2, 1969 | |
| Other | Sep 2, 1969 | 100% | |
| Stefanie Wagaman |
Corporate Director |
Jul 1, 2022 | |
| W-2 Managing Employee |
Jul 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080512000326 | IA | Part a Provider - Home Health Agency | 5092894337 | Practice locations: Tipton, IA |
National Provider Directory
- Tax ID family
- Cedar County
Locations
400 Cedar St
#B1
Tipton, IA 52772
Phone (563) 886-2226
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
400 Cedar St
Tipton, IA 52772-1748
Mailing address
400 Cedar St
Tipton, IA 52772-1748
Phone (563) 886-2226
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 67041 | Other | IA | BLUE CROSS/BLUE SHIELD |
| 0670414 | Medicaid | IA |
Other names
- Cedar County Public Health Nursing Service
Other providers in Tipton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.