Active NPI
Mayflower Homes, Inc.
Doing business as Mayflower Home Inc.
- Skilled Nursing Facility
- Grinnell, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0277
- Legal business name
- MAYFLOWER HOMES, INC.
- Doing business as
- Mayflower Home Inc.
- Practice address
- 616 Broad St
Grinnell, IA 50112-2298 - Phone
- (641) 236-6151
- Fax
- (641) 236-6154
- NPI assigned
- Sep 12, 2005
- Last updated
- Oct 26, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Edward R. Poush
- Title
- Administrator
- Phone
- (641) 236-6151
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 0277 | IA | |
| Skilled Nursing Facility | 314000000X | 0277 | IA | Primary |
Addresses
Primary practice location
616 Broad St
Grinnell, IA 50112-2298
Mailing address
616 Broad St
Grinnell, IA 50112-2298
Phone (641) 236-6151
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0802303 | Medicaid | IA |
Other names 1
- Mayflower Home Inc.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20020930000011 | IA | Part A Provider - Skilled Nursing Facility | 1658288329 | Practice locations: Grinnell, IA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1972598498. Details of each certification follow.
Skilled nursing facility certification: CCN 165481
- Legal name
- MAYFLOWER HOMES INC
- Doing business as
- MAYFLOWER HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 2003
- Last certification
- May 29, 2025
- Beds
- 40
- Ownership / control type
- Church Related
- Organization structure
- Corporation
- Enrollment address
- 616 Broad St
Grinnell, IA 50112-2298 - Nursing home name
- MAYFLOWER HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Mayflower Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Church related
- Certified
- Jan 1, 2003
- Medicare certification status
- Active
- Certified beds
- 40
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D0382745 | Mayflower Home | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Mayflower Homes Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Grinnell, IA
- NPI 1073717153
Ownership & related parties
All disclosed owners & managing parties 74
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Thomas S Moffatt | Adp of the SNF | Mar 1, 2021 | |
| Adp of the SNF | Apr 1, 2021 | ||
| NCS Healthcare of Iowa, LLC | Adp of the SNF | Mar 1, 2021 | |
| Scott Gruhn | Operational/Managerial Control | Jul 14, 2000 | |
| Adp of the SNF | Jul 18, 2018 | ||
| Mayflower Homes Inc | 5% Or Greater Direct Ownership Interest | Apr 1, 1993 | 100% |
| Operational/Managerial Control | Apr 1, 1993 | 100% | |
| Adp of the SNF | Apr 1, 1993 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Vicki Wieck | Operational/Managerial Control | Apr 15, 2024 | |
| RSM US LLP | Adp of the SNF | Mar 1, 2021 | |
| James Ramsey | Corporate Officer | Oct 13, 2020 | |
| Corporate Director | Oct 8, 2020 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Leslie Jaworski | Operational/Managerial Control | Aug 1, 2020 | |
| Kellie McGriff | Corporate Officer | Jul 18, 2018 | |
| Operational/Managerial Control | Jul 18, 2018 | ||
| Adp of the SNF | Jul 18, 2018 | ||
| Brian J Heineman | Operational/Managerial Control | May 6, 2019 | |
| Adp of the SNF | Jul 18, 2018 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Jessica Dillon | Corporate Officer | Oct 13, 2020 | |
| Corporate Director | Oct 8, 2020 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| John Mutti | Corporate Officer | Oct 8, 2022 | |
| Corporate Director | Oct 8, 2020 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Jan 1, 2016 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Cattail Inc | Adp of the SNF | Oct 1, 2024 | |
| BCG Holdings Inc | Adp of the SNF | Oct 1, 2024 | |
| Iowa Health Care Association | Adp of the SNF | Oct 1, 2024 | |
| Anneliese Wiltfang | Operational/Managerial Control | Dec 6, 2024 | |
| Adp of the SNF | Mar 1, 2021 | ||
| Jacob Staroska | Operational/Managerial Control | Dec 7, 2020 | |
| Patrick Mahaffey | Corporate Director | Oct 8, 2024 | |
| Adp of the SNF | Mar 1, 2021 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Meredith Crow | Adp of the SNF | Mar 1, 2021 | |
| Adp of the SNF | Mar 1, 2021 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Ecsi Inc | Adp of the SNF | Oct 1, 2024 | |
| Adp of the SNF | Oct 1, 2024 | ||
| Lisa Jepsen | Corporate Officer | Jul 26, 2022 | |
| Corporate Director | Oct 8, 2020 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Paige L Carlson | Corporate Director | Oct 13, 2020 | |
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Pamela S Vosburg | Corporate Officer | Dec 7, 2009 | |
| Adp of the SNF | Dec 9, 2009 | ||
| Peter Marsho | Corporate Director | Oct 8, 2024 | |
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Adp of the SNF | Oct 1, 2024 | ||
| Ryun, Givens & Company, P.C. | Adp of the SNF | Apr 1, 2021 | |
| Cattail BCG LLC | Adp of the SNF | Oct 1, 2024 | |
| Adp of the SNF | Mar 1, 2021 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| Diane Fairchild | Corporate Director | Oct 8, 2024 | |
| Key Rehabilitation Inc | Adp of the SNF | Oct 1, 2021 | |
| Adp of the SNF | Mar 1, 2021 | ||
| Brighton Consulting Group LLC | Adp of the SNF | Oct 1, 2024 |
Owners & managing parties with NPI records 11
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Adolescent Medicine (Family Medicine) Physician
- Brooklyn, IA
- NPI 1548341035
Adp of the SNF, Operational/Managerial Control
-
dba Martin Health Urbandale 48236
- Long Term Care Pharmacy
- Urbandale, IA
- NPI 1770695884
Adp of the SNF
-
dba GeroPsych, a division of Key Rehabilitation, Inc
- Clinical Psychologist
- Hendersonville, TN
- NPI 1528136249
Adp of the SNF
-
dba GeroPsych, a division of Key Rehabilitation, Inc
- Psychologist
- Gardner, KS
- NPI 1205106457
Adp of the SNF
-
dba GeroPsych, a division of Key Rehabilitation, Inc
- Clinical Psychologist
- McIntosh, MN
- NPI 1295436970
Adp of the SNF
-
dba GeroPsych, a division of Key Rehabilitation, Inc
- Clinical Psychologist
- Fargo, ND
- NPI 1679328975
Adp of the SNF
-
dba GeroPsych, a division of Key Rehabilitation, Inc.
- Psychologist
- Salem, MO
- NPI 1821335613
Adp of the SNF
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Adolescent Medicine (Family Medicine) Physician
- Brooklyn, IA
- NPI 1548341035
Affiliated clinicians 7
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Adolescent Medicine (Family Medicine) Physician
- Brooklyn, IA
- NPI 1548341035
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126483200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1319587200000",
"number": "1972598498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "616 BROAD ST",
"city": "GRINNELL",
"state": "IA",
"postal_code": "501122298",
"telephone_number": "641-236-6151",
"fax_number": "641-236-6154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 BROAD ST",
"city": "GRINNELL",
"state": "IA",
"postal_code": "501122298",
"telephone_number": "641-236-6151",
"fax_number": "641-236-6154"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAYFLOWER HOMES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-12",
"last_updated": "2011-10-26",
"status": "A",
"authorized_official_last_name": "POUSH",
"authorized_official_first_name": "EDWARD",
"authorized_official_middle_name": "R.",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "641-236-6151",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "IA",
"license": "0277",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "IA",
"license": "0277",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0802303",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Mayflower Home Inc.",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Grinnell, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.