NPIMap

Organization Active NPI

Sioux Center Health

Doing business as Sioux Center Health Home Care and Hospice

  • Community Based Hospice Care Agency
  • Sioux Center, IA
National Provider Identifier
1932279254
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
840080H Issued in IA
Legal business name
SIOUX CENTER HEALTH
Doing business as
Sioux Center Health Home Care and Hospice
Practice address
1400 7TH Ave SE
Sioux Center, IA 51250-1199
Phone
(712) 722-8108
Fax
(712) 722-1294
NPI assigned
Nov 8, 2006
Last updated
Apr 20, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SIOUX CENTER HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Authorized official

Name
Crystal Richter
Title
Cfo
Phone
(712) 722-8153

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 840080H IA Primary

Addresses

Primary practice location

1400 7TH Ave SE
Sioux Center, IA 51250-1199

Mailing address

1101 9TH St SE
Sioux Center, IA 51250-2501
Phone (712) 722-1271

Other identifiers 1

IdentifierTypeStateIssuer
0615195MedicaidIA

Other names 1

  • Sioux Center Health Home Care and Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030602000024 IA Part A Provider - Hospice 9032027495 Practice locations: Sioux Center, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932279254. Details of each certification follow.

Hospice certification: CCN 161519

Legal name
SIOUX CENTER HEALTH
Doing business as
SIOUX CENTER HEALTH HOME CARE AND HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 24, 1991
Last certification
Sep 10, 2020
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Feb 27, 1948 in IA
Enrollment address
1400 7TH Ave SE
Sioux Center, IA 51250-1199

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Sioux Center Health Home Care and HospiceCCN 161519 · All quality measures
Ownership
Non-Profit
Certified
Oct 24, 1991
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Sioux Center Health11 organizations share this tax ID, including this one
Part of
Sioux Center Health

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Kim Vonk Individual W-2 Managing Employee Oct 1, 2018
Karen L Bentsen Individual W-2 Managing EmployeeSenior Services Officer Dec 16, 2019
Jason R Koelewyn Individual W-2 Managing EmployeeMD; May 1, 2024
Daniel T Vandenbosch Individual W-2 Managing EmployeeMD; Feb 1, 2021
Jennifer Roghair Individual Operational/Managerial Control Jan 1, 2020
Jenni Mellema Individual W-2 Managing EmployeeHospice and Homecare Manager Dec 1, 2022
Cory Nelson Individual Corporate OfficerCeo Sep 24, 2018
Sioux Center Health Organization, Sioux Center, IA Non-profit Operational/Managerial Control Oct 24, 1991
Crystal Richter Individual Corporate OfficerCfo Sep 1, 2022

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Sioux Center HealthSioux Center, IA, CCN 161346 Hospital Operational/Managerial Control Oct 17, 2007
Sioux Center HealthSioux Center, IA, CCN 16Z346 Hospital Operational/Managerial Control Oct 17, 2007
Royale Meadows Care CenterSioux Center, IA, CCN 165157 Skilled nursing facility Operational/Managerial Control Dec 9, 2022

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 10

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": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1932279254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 9TH ST SE",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512502501",
            "telephone_number": "712-722-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 7TH AVE SE",
            "city": "SIOUX CENTER",
            "state": "IA",
            "postal_code": "512501199",
            "telephone_number": "712-722-8108",
            "fax_number": "712-722-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIOUX CENTER HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SIOUX CENTER HEALTH",
        "enumeration_date": "2006-11-08",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "RICHTER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "712-722-8153"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IA",
            "license": "840080H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0615195",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sioux Center Health Home Care and Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sioux Center Health Home Care and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux Center, IA

Sources for this page

Verify at the official NPI Registry.