ST. JOSEPH'S HOME OF OUR LADY OF MT CARMEL INC (NPI# 1740270735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740270735 |
| Entity Type | Organization |
| Organization Name | ST. JOSEPH'S HOME OF OUR LADY OF MT CARMEL INC |
| Practice Address |
9244 29th Ave Kenosha WI 53143-6602 |
| Practice Telephone | 2626940080 |
| Practice Fax Number | 2629258137 |
| Mailing Telephone | 2626940080 |
| Mailing Fax Number | 2629258137 |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2011-08-11 |
| Authorized Official Name | SUSIE K EIDSOR (BUSINESS MANAGER) |
| Authorized Official Telephone | 2629258104 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 2332 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20154500 | 05 |
| Street Address |
9244 29TH AVE |
| City | KENOSHA |
| State | WI |
| Zip Code | 53143-6602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427672732 | Collin Scott Barber | Physical Therapist | 9244 29th Ave, Kenosha, WI 53143-6602 | 2020-06-02 |
| 1821514605 | Ariel R Skavdahl | Physical Therapist | 9244 29th Ave, Kenosha, WI 53143-6602 | 2017-08-14 |
| 1376991430 | Terese Nadboralski | Occupational Therapist | 9244 29th Ave, Kenosha, WI 53143-6602 | 2016-05-31 |
| 1336569201 | Sarah Gyurina | Occupational Therapist | 9244 29th Ave, Kenosha, WI 53143-6602 | 2014-04-18 |
| 1215271762 | Tina M Heebsh | Occupational Therapy Assistant | 9244 29th Ave, Kenosha, WI 53143-6602 | 2012-11-23 |
| 1255675799 | Kathleen J Summers | Physical Therapy Assistant | 9244 29th Ave, Kenosha, WI 53143-6602 | 2012-11-21 |
| 1588968952 | Sarah Ann Dosemagen | Physical Therapy Assistant | 9244 29th Ave, Kenosha, WI 53143-6602 | 2010-12-29 |
| 1295046043 | Sandra Lee Jonas | Occupational Therapist | 9244 29th Ave, Kenosha, WI 53143-6602 | 2010-06-27 |
| 1245472166 | Lori Ann Freisinger | Clinic/Center | 9244 29th Ave, Attn: Therapy Dept, Kenosha, WI 53143-6602 | 2009-03-25 |
| 1609040476 | Dianna Kaczmarek | Occupational Therapist | 9244 29th Ave, Kenosha, WI 53143-6602 | 2008-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891262275 | Shanda L Goecks | Registered Nurse | 6916 26th Ave, Kenosha, WI 53143 | 2018-10-24 |
| 1689942989 | Racine Kenosha Community Action Agency | Public Health or Welfare | 2000 63rd Street, Kenosha, WI 53143 | 2011-12-01 |
| 1538497797 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7525 Sheridan Rd, Kenosha, WI 53143 | 2009-11-30 |
| 1497929012 | Ebba M Johnson | Physical Therapist | 524 74th Street, Kenosha, WI 53143 | 2008-04-15 |
| 1770789489 | Kenosha Community Health Center, Inc | Family Medicine | 6226 14th Ave, Kenosha, WI 53143 | 2007-06-21 |
| 1558413161 | Junith M Thompson | Obstetrics & Gynecology | 6530 Sheridan Road, Kenosha, WI 53143 | 2007-01-17 |
| 1154471332 | Ljh Ambulance, Inc | Ambulance | 6329 28th Ave, Kenosha, WI 53143 | 2007-01-11 |
| 1578625794 | Michael A Schellpfeffer Md Ob Gyn Sc | Obstetrics & Gynecology | 1400 75th Street, Kenosha, WI 53143 | 2006-12-14 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
| Find all providers in zip 53143 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801006978 | Midway Manor Corp. | Skilled Nursing Facility | 1519 60th St, Kenosha, WI 53140-3954 | 2007-05-23 |
| 1922179597 | Extendicare Homes, Inc. | Skilled Nursing Facility | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2006-11-13 |
| 1992752380 | Beverly Enterprises - Wisconsin Inc | Skilled Nursing Facility | 1703 60th St, Kenosha, WI 53140-3986 | 2006-05-30 |
| 1609823723 | Heartland-washington Manor of Kenosha Wi LLC | Skilled Nursing Facility | 3100 Washington Rd, Kenosha, WI 53144-1604 | 2006-05-27 |
| 1558329185 | Brookside Care Center | Skilled Nursing Facility | 3506 Washington Rd, Kenosha, WI 53144 | 2006-05-03 |
| 1063052488 | Elaine Romenesko | Skilled Nursing Facility | 1703 60th St, Kenosha, WI 53140-3986 | 2020-01-14 |
| 1730665159 | The Manor of Kenosha LLC | Skilled Nursing Facility | 3100 Washington Rd, Kenosha, WI 53144-1604 | 2018-07-18 |
| 1083127641 | Crossroads Care Center of Kenosha | Skilled Nursing Facility | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2017-11-06 |
| 1295253045 | Nsh Kenosha LLC | Skilled Nursing Facility | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2017-08-31 |
| 1700312436 | The Bay At Waters Edge Health and Rehabilitation LLC | Skilled Nursing Facility | 3415 Sheridan Rd, Kenosha, WI 53140 | 2017-05-01 |
| Find all providers in KENOSHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.