NPIMap

Organization Active NPI

Hegg Memorial Hospital

  • Home Health Agency
  • Rock Valley, IA
National Provider Identifier
1912988387
Registry record updated Jul 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
8400049H Issued in IA
Legal business name
HEGG MEMORIAL HOSPITAL
Practice address
1202 21St Ave
Rock Valley, IA 51247-1420
Phone
(712) 476-8050
Fax
(712) 476-8024
NPI assigned
Nov 10, 2005
Last updated
Jul 27, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
HEGG MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 27, 2009

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

Authorized official

Name
Larae Fluit, RN
Title
Director
Phone
(712) 476-8051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 8400049H IA Primary

Addresses

Primary practice location

1202 21St Ave
Rock Valley, IA 51247-1420

Mailing address

1202 21St Ave
Rock Valley, IA 51247-1420
Phone (712) 476-8050

Other identifiers 1

IdentifierTypeStateIssuer
0672360MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090902000475 IA Part A Provider - Home Health Agency 5193718757 Practice locations: Rock Valley, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912988387. Details of each certification follow.

Home health agency certification: CCN 167236

Legal name
HEGG MEMORIAL HOSPITAL
Doing business as
HEGG HOME HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 27, 1995
Last certification
Nov 4, 2020
Ownership / control type
Proprietary
Organization structure
CorporationNon-profit
Incorporated
in IA
Enrollment address
1202 21St Ave
Rock Valley, IA 51247-1420
HHA Branch

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Hegg Home Health CareCCN 167236 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Mar 27, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Hegg Memorial Hospital4 organizations share this tax ID, including this one
Part of
Hegg Memorial Hospital

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
William Slater Individual Corporate Officer Nov 9, 2018
Glenn Alan Zevenbergen Individual Corporate Director Jun 15, 2009
Hegg Memorial Hospital Organization, Rock Valley, IA Non-profit Operational/Managerial Control Jun 15, 2009 100%
Sarah Rozeboom Individual W-2 Managing EmployeeAdministrator Apr 3, 2023
Melinda Deweerd Individual W-2 Managing EmployeeClinical Coordinator Apr 3, 2023

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 5

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": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248652800000",
    "number": "1912988387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 21ST AVE",
            "city": "ROCK VALLEY",
            "state": "IA",
            "postal_code": "512471420",
            "telephone_number": "712-476-8050",
            "fax_number": "712-476-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 21ST AVE",
            "city": "ROCK VALLEY",
            "state": "IA",
            "postal_code": "512471420",
            "telephone_number": "712-476-8050",
            "fax_number": "712-476-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEGG MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEGG MEMORIAL HOSPITAL",
        "enumeration_date": "2005-11-10",
        "last_updated": "2009-07-27",
        "status": "A",
        "authorized_official_last_name": "FLUIT",
        "authorized_official_first_name": "LARAE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "712-476-8051",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IA",
            "license": "8400049H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0672360",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Valley, IA

Sources for this page

Verify at the official NPI Registry.