NPIMap

Organization Active NPI

Community Hospital Inc

Doing business as George C. Grape Community Hospital

  • Critical Access Hospital
  • Hamburg, IA
National Provider Identifier
1932294071
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
360067H Issued in IA
Legal business name
COMMUNITY HOSPITAL INC
Doing business as
George C. Grape Community Hospital
Practice address
2959 US Highway 275
Hamburg, IA 51640-5052
Phone
(712) 382-1515
NPI assigned
Oct 4, 2006
Last updated
Jun 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Authorized official

Name
Cristin A Hendrickson
Title
Ceo/Administrator
Phone
(712) 382-1515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 360067H IA Primary

Addresses

Primary practice location

2959 US Highway 275
Hamburg, IA 51640-5052

Mailing address

2959 US Highway 275
Hamburg, IA 51640-5052
Phone (712) 382-1515

Other names 1

  • George C. Grape Community Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000696 IA Part A Provider - Critical Access Hospital 6103860564 Receives reassigned benefits from 7 practitioners
Practice locations: Hamburg, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932294071. Details of each certification follow.

Hospital certification: CCN 161324

Legal name
COMMUNITY HOSPITAL INC
Doing business as
GEORGE C GRAPE COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 1, 2001
Last certification
Sep 30, 2021
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 16, 1953 in IA
Enrollment address
2959 US Highway 275
Hamburg, IA 51640-5052
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
George C Grape Community HospitalCCN 161324 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Grape Community Hospita3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Cristin a Hendrickson Individual Corporate OfficerCeo/Administrator Nov 21, 2021
W-2 Managing EmployeeCeo/Administrator Nov 21, 2021
Operational/Managerial ControlCeo/Administrator Nov 21, 2021
Angela S Ettleman Individual Corporate Officer Feb 5, 2024
Corporate Director Feb 4, 2019
Michael J Ourada Individual Contracted Managing EmployeeChief of Staff Jan 1, 2024
Operational/Managerial ControlChief of Staff Jan 1, 2024
Arthur K Claiborne Individual Corporate Officer Feb 5, 2024
Corporate Director Feb 5, 2024
Thomas H Largen Individual Corporate Director Jul 23, 2025
Danny R Osborn Individual Corporate Director Feb 5, 2024
Troy D Hendrickson Individual Corporate Officer Feb 5, 2024
Corporate Director Feb 7, 2022
Melissa J Travis Individual Corporate Director Feb 5, 2024

Owners & managing parties with NPI records 1

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
Medical ClinicTabor, IA, CCN 163836 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Dec 31, 2023
Dec 31, 2023
Medical ClinicHamburg, IA, CCN 163834 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Dec 31, 2023
Dec 31, 2023
Medical ClinicSidney, IA, CCN 163833 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Dec 31, 2023
Dec 31, 2023

Owned or controlled facilities with NPI records 3

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

  • Medical Clinic LLC
    • Rural Health Clinic/Center
    • Tabor, IA
    • NPI 1841263233

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Medical Clinic LLC
    • Rural Health Clinic/Center
    • Sidney, IA
    • NPI 1871566265

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Medical Clinic LLC
    • Rural Health Clinic/Center
    • Hamburg, IA
    • NPI 1972575595

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 8

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 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1932294071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2959 US HIGHWAY 275",
            "city": "HAMBURG",
            "state": "IA",
            "postal_code": "516405052",
            "telephone_number": "712-382-1515",
            "fax_number": "712-382-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2959 US HIGHWAY 275",
            "city": "HAMBURG",
            "state": "IA",
            "postal_code": "516405052",
            "telephone_number": "712-382-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "HENDRICKSON",
        "authorized_official_first_name": "CRISTIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "712-382-1515"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IA",
            "license": "360067H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "George C. Grape Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "George C. Grape Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hamburg, IA

Sources for this page

Verify at the official NPI Registry.