County of Louisa

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1962480962 Issued in IA

Legal business name

COUNTY OF LOUISA

Practice address

12635 County Road G56 Ste 103
Wapello, IA 52653-9564

Phone

(319) 523-3981

Fax

(319) 523-8408

NPI assigned

Jan 9, 2006

Organization subpart

No

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

Authorized official

Name

Brandy Smith

Title

Manager

Phone

(319) 523-3981

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Louisa County Public Health Nursing Service Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Home health agency certification: CCN 167050

Legal name

COUNTY OF LOUISA

Doing business as

LOUISA COUNTY PUBLIC HEALTH NURSING SERVICE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 1, 1971

Last certification

Jan 8, 2020

Ownership / control type

Government Operated

Organization structure

GovernmentNon-profit

Enrollment address

12635 County Road G56
Ste 103
Wapello, IA 52653-9564

Listed as

Louisa County PHNSCCN 167050

Ownership

Government Operated

Certified

Oct 1, 1971

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide

Tax ID family

Louisa County Community Services3 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.

• Louisa County

  • Home Health Agency
  • Wapello, IA
  • NPI 1023432556
  NPD tax ID
• Louisa County Community Services

  • Case Management Agency
  • Wapello, IA
  • NPI 1457403701
  NPD tax ID

Locations

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.

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680048000000",
    "number": "1962480962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 JL HODGES AVE.",
            "city": "WAPELLO",
            "state": "IA",
            "postal_code": "52653",
            "telephone_number": "319-523-3981",
            "fax_number": "319-523-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12635 COUNTY ROAD G56 STE 103",
            "city": "WAPELLO",
            "state": "IA",
            "postal_code": "526539564",
            "telephone_number": "319-523-3981",
            "fax_number": "319-523-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LOUISA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "319-523-3981"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IA",
            "license": "1962480962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC/BS PROVIDER #",
            "identifier": "67050",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0670505",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Louisa County Public Health Nursing Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Louisa County Public Health Nursing Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Bartenhagen, LISW
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• All providers in Wapello, IA
• Home Health Agency in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.