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Organization Active NPI

Iowa City Hospice, Inc.

  • Community Based Hospice Care Agency
  • Iowa City, IA
National Provider Identifier
1962447250
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
IOWA CITY HOSPICE, INC.
Practice address
1526 Sycamore St
Iowa City, IA 52240-6021
Phone
(319) 351-5665
Fax
(319) 351-5729
NPI assigned
Jun 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Authorized official

Name
Karla Kamal
Title
Chief Executive Officer
Phone
(319) 356-5665

Specialties & licenses 1

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

Addresses

Primary practice location

1526 Sycamore St
Iowa City, IA 52240-6021

Mailing address

1526 Sycamore St
Iowa City, IA 52240-6021
Phone (319) 351-5665

Other identifiers 2

IdentifierTypeStateIssuer
61507OtherIAWELLMARK BCBS OF IOWA
0615070MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060804000305 IA Part A Provider - Hospice 1456354760 Practice locations: Iowa City, IA

Hospice certification: CCN 161507

Legal name
IOWA CITY HOSPICE, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 9, 1987
Last certification
Feb 25, 2021
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Incorporated
Mar 19, 1981 in IA
Enrollment address
1524 Sycamore St
Iowa City, IA 52240-6021

Care Compare: Hospice

Medicare Care Compare
Listed as
Iowa City HospiceCCN 161507 · All quality measures
Ownership
Non-Profit
Certified
Jul 9, 1987
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Iowa City Hospice2 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.

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
Iowa Care Community Inc Organization, Iowa City, IA Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 10, 2021 100%
Kara Thoma Individual Corporate DirectorDirector May 10, 2021
W-2 Managing Employee May 10, 2021
Sara Caven Individual Corporate Officer Apr 17, 2023
W-2 Managing EmployeeClinical Director Apr 17, 2023
Peter J Milder Individual W-2 Managing Employee Oct 3, 2022
Renee Stribling Individual W-2 Managing EmployeeDirector of Finance Apr 1, 2024
Randy McDonough Individual Corporate OfficerSecretary May 10, 2021
Michelle T Weckmann Individual W-2 Managing Employee Feb 23, 2024
Sara Krieger Individual Corporate OfficerBoard Chair Jul 22, 2022
Corporate DirectorDirector May 10, 2021
W-2 Managing EmployeeCeo May 10, 2021

Owners & managing parties with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643328000000",
    "number": "1962447250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 SYCAMORE ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522406021",
            "telephone_number": "319-351-5665",
            "fax_number": "319-351-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 SYCAMORE ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522406021",
            "telephone_number": "319-351-5665",
            "fax_number": "319-351-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA CITY HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A",
        "authorized_official_last_name": "KAMAL",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "319-356-5665"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS OF IOWA",
            "identifier": "61507",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0615070",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.