NPIMap

Organization Active NPI

Palo Alto County Hospital

Doing business as Palo Alto Community Health

  • Home Health Agency
  • Emmetsburg, IA
National Provider Identifier
1992708531
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
167049 Issued in IA
Legal business name
PALO ALTO COUNTY HOSPITAL
Doing business as
Palo Alto Community Health
Practice address
3201 1St St
Emmetsburg, IA 50536-2516
Phone
(712) 852-5419
Fax
(712) 852-5513
NPI assigned
May 27, 2005
Last updated
Dec 3, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
PALO ALTO COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Authorized official

Name
Mr. Thomas J Lee
Title
Administrator/Ceo
Phone
(712) 852-5401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 167049 IA Primary

Addresses

Primary practice location

3201 1St St
Emmetsburg, IA 50536-2516

Mailing address

3201 1St St
Emmetsburg, IA 50536-2516
Phone (712) 852-5500

Other identifiers 2

IdentifierTypeStateIssuer
67049OtherIABC COMMUNITY HLTH PROV #
0671222MedicaidIA

Other names 1

  • Palo Alto Community Health Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address HIM@pamhn.cernerdirect.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050926000783 IA Part A Provider - Home Health Agency 4486563061 1 other NPI on this enrollment
Practice locations: Emmetsburg, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992708531. Details of each certification follow.

Home health agency certification: CCN 167049

Legal name
PALO ALTO COUNTY HOSPITAL
Doing business as
PALO ALTO COMMUNITY HEALTH SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 11, 1971
Last certification
Dec 9, 2020
Ownership / control type
Government Operated
Organization structure
GovernmentProprietary
Enrollment address
3201 1St St
Emmetsburg, IA 50536-2516
HHA Branch

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Palo Alto Community HealthCCN 167049 · All quality measures
Overall star rating
3 of 5
Ownership
Government Operated
Certified
Aug 11, 1971
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
Palo Alto County Hospit9 organizations share this tax ID, including this one
Part of
Palo Alto County Hospit

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Coleen R Ruddy Individual W-2 Managing Employee Jan 10, 2012
Cynthia Magee Individual Corporate Director Jan 23, 2019
Terry Naig Individual Corporate Director Aug 22, 2012
Dawn Schmidt Individual Corporate Director Aug 27, 2008
Sarah Strohman Individual Corporate DirectorAgency Director Jun 23, 2017 100%
Operational/Managerial ControlAgency Director Jun 23, 2017 100%
Palo Alto County Hospital Organization, Emmetsburg, IA Non-profit Operational/Managerial Control Jan 10, 2012
Collette Johnson Individual Corporate OfficerCfo Jun 20, 2016
W-2 Managing EmployeeCfo Jun 20, 2016
Operational/Managerial ControlCfo Jun 20, 2016
Melanie Flynn Individual Corporate Director Jan 27, 2021
Richard Brennan Individual Corporate Director Feb 20, 2019
Jana Harris Individual Corporate Director Jan 23, 2019
Jonathan Dean Moe Individual Contracted Managing EmployeeCeo Feb 1, 2021
Corporate OfficerCeo Feb 1, 2021
Operational/Managerial ControlCeo Feb 1, 2021
Burt J. Hobart Individual Corporate Director Jan 2, 2008

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Palo Alto County HospitalEmmetsburg, IA, CCN 161357 Hospital Operational/Managerial Control Jan 2, 2013
Palo Alto County HospitalEmmetsburg, IA, CCN 16Z357 Hospital Operational/Managerial Control Jan 2, 2008
Hospice of Palo Alto CountyEmmetsburg, IA, CCN 161530 Hospice Operational/Managerial Control Sep 9, 1993
Family Practice Clinic West BendWest Bend, IA, CCN 163417 Rural health clinic Operational/Managerial Control Sep 12, 1994

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1992708531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 1ST ST",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "505362516",
            "telephone_number": "712-852-5500",
            "fax_number": "712-852-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 1ST ST",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "505362516",
            "telephone_number": "712-852-5419",
            "fax_number": "712-852-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALO ALTO COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALO ALTO COUNTY HOSPITAL",
        "enumeration_date": "2005-05-27",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "712-852-5401",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IA",
            "license": "167049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC COMMUNITY HLTH PROV #",
            "identifier": "67049",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0671222",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "HIM@pamhn.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "PACHS Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3201 1st St",
            "city": "Emmetsburg",
            "state": "IA",
            "country_code": "US",
            "postal_code": "505362516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Palo Alto Community Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Palo Alto Community Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Emmetsburg, IA

Sources for this page

Verify at the official NPI Registry.