NPIMap

Organization Active NPI

Hospice of Washington County Inc

  • Community Based Hospice Care Agency
  • Washington, IA
National Provider Identifier
1942202452
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HOSPICE OF WASHINGTON COUNTY INC
Practice address
948 E 11TH St
Washington, IA 52353-2633
Phone
(319) 653-7321
Fax
(319) 653-4057
NPI assigned
Aug 15, 2005
Last updated
Jun 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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

Authorized official

Name
Ms. Jean Wollenberg
Title
Executive Director
Phone
(319) 653-7321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

948 E 11TH St
Washington, IA 52353-2633

Mailing address

948 E 11TH St
Washington, IA 52353-2633
Phone (319) 653-7321

Other identifiers 2

IdentifierTypeStateIssuer
0615443MedicaidIA
161544OtherIAWELLMARK BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030807000030 IA Part A Provider - Hospice 3971414541 Practice locations: Washington, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942202452. Details of each certification follow.

Hospice certification: CCN 161544

Legal name
HOSPICE OF WASHINGTON COUNTY, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 1, 1996
Last certification
Apr 28, 2021
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Incorporated
May 2, 1988 in IA
Enrollment address
948 E 11TH St
Washington, IA 52353-2633

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice of Washington CountyCCN 161544 · All quality measures
Ownership
Non-Profit
Certified
Feb 1, 1996
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

948 E 11th St
Washington, IA 52353
Phone (319) 653-7321

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
Katrina Altenhofen Individual Corporate OfficerExecutive Officer Nov 21, 2016
Operational/Managerial Control Nov 21, 2016
Mark Beatty Individual Corporate DirectorBoard Member Jan 1, 2022
Lindsay Wheeler Individual Corporate OfficerFinancial Officer Apr 10, 2015
Paul W Towner Individual Contracted Managing EmployeeMedical Director Jul 30, 2021
Mary Ruth Individual Corporate DirectorBoard Member Jan 1, 2022

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 8

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": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371081600000",
    "number": "1942202452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "948 E 11TH ST",
            "city": "WASHINGTON",
            "state": "IA",
            "postal_code": "523532633",
            "telephone_number": "319-653-7321",
            "fax_number": "319-653-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "948 E 11TH ST",
            "city": "WASHINGTON",
            "state": "IA",
            "postal_code": "523532633",
            "telephone_number": "319-653-7321",
            "fax_number": "319-653-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE OF WASHINGTON COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2013-06-13",
        "status": "A",
        "authorized_official_last_name": "WOLLENBERG",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "319-653-7321",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0615443",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "161544",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IA

Sources for this page

Verify at the official NPI Registry.