NPIMap

Organization Active NPI

Mitchell County

Doing business as Mitchell County Home Health Care/Public Health

  • Home Health Agency
  • Osage, IA
National Provider Identifier
1952398810
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MITCHELL COUNTY
Doing business as
Mitchell County Home Health Care/Public Health
Practice address
415 Pleasant St
Suite 100
Osage, IA 50461-1935
Phone
(641) 832-3500
Fax
(641) 832-3501
NPI assigned
Oct 5, 2005
Last updated
Nov 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Authorized official

Name
Mrs. Lavonne Wolf, R.N., B.S.N
Title
R.N. Administrator
Phone
(641) 832-3502

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

415 Pleasant St
Suite 100
Osage, IA 50461-1935

Mailing address

415 Pleasant St
Suite 100
Osage, IA 50461-1935
Phone (641) 832-3500

Other identifiers 3

IdentifierTypeStateIssuer
0670422MedicaidIA
67042OtherIABCBS
1600675870OtherIACLID #

Other names 1

  • Mitchell County Home Health Care/Public Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050310000360 IA Part A Provider - Home Health Agency 0345294526 Practice locations: Osage, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952398810. Details of each certification follow.

Home health agency certification: CCN 167042

Legal name
MITCHELL COUNTY
Doing business as
MITCHELL COUNTY HOME HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 1, 1970
Last certification
Nov 10, 2020
Ownership / control type
Proprietary
Organization structure
GovernmentNon-profit
Enrollment address
415 Pleasant St
Ste 100
Osage, IA 50461-1935

Care Compare: Home health agency

Medicare Care Compare
Listed as
Mitchell County Home Health Care/ Public HealthCCN 167042 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Apr 1, 1970
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Mitchell County2 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.

  • Mitchell County

    dba Mitchell County Home Health Care and Public Health

    • Public Health or Welfare Agency
    • Osage, IA
    • NPI 1003286683
    NPD tax ID

Locations

102 Plaza Ln
Osage, IA 50461
Phone (641) 832-3500

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Mitchell County Organization, Osage, IA 5% Or Greater Direct Ownership Interest Jun 1, 1970 100%
Operational/Managerial Control Jun 1, 1970
Brenda Miller Individual W-2 Managing EmployeeChairperson, Board of Health Jan 1, 2017
Laura Huisman Individual W-2 Managing Employee Mar 5, 2019

Practitioners & affiliated clinicians

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": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1952398810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 PLEASANT ST",
            "address_2": "SUITE 100",
            "city": "OSAGE",
            "state": "IA",
            "postal_code": "504611935",
            "telephone_number": "641-832-3500",
            "fax_number": "641-832-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 PLEASANT ST",
            "address_2": "SUITE 100",
            "city": "OSAGE",
            "state": "IA",
            "postal_code": "504611935",
            "telephone_number": "641-832-3500",
            "fax_number": "641-832-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "LAVONNE",
        "authorized_official_title_or_position": "R.N. ADMINISTRATOR",
        "authorized_official_telephone_number": "641-832-3502",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N., B.S.N"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0670422",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "67042",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLID #",
            "identifier": "1600675870",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mitchell County Home Health Care/Public Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Osage, IA

Sources for this page

Verify at the official NPI Registry.