Fort Dodge Health and Rehabilitation – Skilled Nursing Facility, NPI 1104110642

Fort Dodge Health and Rehabilitation is a healthcare provider. based in Fort dodge, Iowa. specializing in Skilled Nursing Facility. The NPI Number for Fort Dodge Health and Rehabilitation is 1104110642

Main info

Organization
Name
Fort Dodge Health and Rehabilitation
NPI
1104110642
Phone
(515) 576-7226
Address
728 14TH AVE N
Authorized Official
MS. SOON BURNAM TREASURER
Enumeration Date
1 June 2011
Last Update Date
23 February 2021

Contacts

Main Contact
https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness90
Years active:15State licenses:0Updated within 12 months

Provider Addresses for Fort Dodge Health and Rehabilitation

  • 728 14TH AVE N

    FORT DODGE, IA 505017016

    Phone: (515) 576-7226

    Fax: (515) 573-2865

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-07-19

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20110719000595OSkilled Nursing FacilityIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 50501)

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Reviews

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Frequently asked questions

What federal number belongs to Fort Dodge Health and Rehabilitation?
The federal identifier for Fort Dodge Health and Rehabilitation is NPI 1104110642.
Is Fort Dodge Health and Rehabilitation's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does Fort Dodge Health and Rehabilitation work in?
You can think of Fort Dodge Health and Rehabilitation as practicing within Skilled Nursing Facility. Clinical services aligned with this taxonomy classification.
What location metadata exists for Fort Dodge Health and Rehabilitation?
The page summarizes Fort Dodge, Iowa for Fort Dodge Health and Rehabilitation; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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