Community Nursing Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

120205 Issued in IA

Legal business name

COMMUNITY NURSING HOME INC

Doing business as

Community Nursing Home

Practice address

115 N Hilton
Clarksville, IA 50619-7936

Phone

(319) 278-4900

Fax

(319) 278-4166

NPI assigned

Jun 21, 2005

Last updated

Jan 18, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Henry J Mennenga

Title

Vice President

Phone

(319) 278-4900

Specialties & licenses 3

Addresses

Other names 1

• Community Nursing Home Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952307472. Details of each certification follow.

• CCN 165495 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 165495

Legal name

COMMUNITY NURSING HOME INC

Doing business as

CLARKSVILLE SKILLED NURSING AND REHABILITATION CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 1, 2004

Last certification

Apr 3, 2025

Beds

42

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Enrollment address

115 N Hilton St
Clarksville, IA 50619-7936

Nursing home name

CLARKSVILLE SKILLED NURSING & REHAB CENTER

Listed as

Clarksville Skilled Nursing & Rehab CenterCCN 165495 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

4 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Apr 1, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

4234.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Clarksville Skilled Nursing Rehab Ctr2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Community Nursing Home Inc

  • Custodial Care Facility
  • Clarksville, IA
  • NPI 1265516801
  NPD tax ID

Locations

All disclosed owners & managing parties 59

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

Owners & managing parties with NPI records 3

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

• Blue Stone Therapy Inc.

  • Physical Medicine & Rehabilitation Physician
  • Urbandale, IA
  • NPI 1932797297

  Adp of the SNF

  CMS ownership
• Lee O Fagre, MD

  • Family Medicine Physician
  • Waverly, IA
  • NPI 1982649018

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Ryka Incorporated

  dba Meyer Pharmacy

  • Community/Retail Pharmacy
  • Waverly, IA
  • NPI 1194876581

  Adp of the SNF

  CMS ownership

Affiliated clinicians 4

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

• Jodi Bangasser, ARNP

  • Primary Care Nurse Practitioner
  • Charles City, IA
  • NPI 1023465267

  Nursing home

  Care Compare affiliation
• Julie Marie Cousin, NP

  • Family Nurse Practitioner
  • Waverly, IA
  • NPI 1598238347

  Nursing home

  Care Compare affiliation
• Lee O Fagre, MD

  • Family Medicine Physician
  • Waverly, IA
  • NPI 1982649018

  Nursing home

  Care Compare affiliation
• Kaitlin Hilmer, ARNP, FNP-C

  • Family Nurse Practitioner
  • Waverly, IA
  • NPI 1033924600

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1952307472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N HILTON",
            "city": "CLARKSVILLE",
            "state": "IA",
            "postal_code": "506197936",
            "telephone_number": "319-278-4900",
            "fax_number": "319-278-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N HILTON",
            "city": "CLARKSVILLE",
            "state": "IA",
            "postal_code": "506197936",
            "telephone_number": "319-278-4900",
            "fax_number": "319-278-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY NURSING HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "MENNENGA",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "319-278-4900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "120205",
            "primary": true
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": "IA",
            "license": "120205",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "IA",
            "license": "120205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chelsea Ann Capper
• Valerie J Chesnut, LISW, RPT
• City of Clarksville (Clarksville Ambulance Service)
• Clarksville Community School District
• Community Nursing Home Inc
• Sharon Duclos, MD
• Courtney Hoelscher, ARNP
• Kathleen B Lopez, RDN
• Holly Meyer, LMFT
• Madelyn Morris

• Skilled Nursing Facility in Clarksville, IA
• Providers in Clarksville, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.