Organization Active NPI

Res-Care Wisconsin, Inc.

  • Home Health Agency
  • Oshkosh, WI
National Provider Identifier
1003072091
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
RES-CARE WISCONSIN, INC.
Practice address
2020 W 9TH Ave
Oshkosh, WI 54903-2128
Phone
(800) 866-0860
NPI assigned
Jul 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Authorized official

Name
Ms. Deena Ombres
Title
Privacy Officer
Phone
(502) 394-2387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X WI Primary

Addresses

Primary practice location

2020 W 9TH Ave
Oshkosh, WI 54903-2128

Mailing address

9901 Linn Station Rd
Louisville, KY 40223-3808
Phone (800) 866-0860

Other identifiers 1

IdentifierTypeStateIssuer
41505900MedicaidWI

Other names 1

  • RCHC Oshkosh Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

2020 W 9th Ave
Oshkosh, WI 54904
Phone (920) 233-2080

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Olivia Kirtley Individual Corporate Director May 7, 2009
Kevin G Fisher Individual Corporate OfficerAssistant Treasurer Apr 29, 2011
Paul Dunn Individual Corporate Director May 7, 2009
Patrick G Kelley Individual Corporate OfficerPresident Jun 23, 2008
Corporate Director Jun 23, 2008 25%
Corporate OfficerPresident Jun 23, 2008 25%
David Braddock Individual Corporate Director May 7, 2009
Ronald Geary Individual Corporate Director May 7, 2009
James H Bloem Individual Corporate Director May 7, 2009
Robert M Leblanc Individual Corporate Director May 7, 2009
Steven S Reed Individual Corporate OfficerSecretary May 2, 2016 100%
Brightspring Health Holdings Corp Organization, Louisville, KY Created for acquisition, For-profit 5% Or Greater Indirect Ownership Interest Dec 22, 2010
John Dennis Humble Individual Corporate Director May 7, 2009
Res-Care Inc Organization, Louisville, KY 5% Or Greater Direct Ownership Interest Mar 6, 1998 100%
William Brock Individual Corporate Director May 7, 2009
Marilyn Hannagan Individual W-2 Managing Employee Nov 1, 2010
David W Miles Individual Corporate OfficerTreasurer Jun 23, 2008
Corporate Director Jun 23, 2008 25%
Corporate OfficerTreasurer/Secretary Jun 23, 2008
Melissa Bardo Individual W-2 Managing EmployeeExecutive Director Jan 31, 2012 100%
David Waskey Individual Corporate OfficerSecretary Jun 23, 2008
David D Rhodes Individual Corporate Director Oct 8, 2010 25%
Tamara L Barta Individual Corporate Director Oct 8, 2010 25%
Ralph Gronefeld Individual Corporate Director May 7, 2009
Robert Hallagan Individual Corporate Director May 7, 2009
Kimberly Wing Individual W-2 Managing EmployeeAdministrator Jan 31, 2012 100%

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1003072091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 LINN STATION RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402233808",
            "telephone_number": "800-866-0860",
            "fax_number": "502-420-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W 9TH AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549032128",
            "telephone_number": "800-866-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RES-CARE WISCONSIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-30",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "OMBRES",
        "authorized_official_first_name": "DEENA",
        "authorized_official_title_or_position": "PRIVACY OFFICER",
        "authorized_official_telephone_number": "502-394-2387",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41505900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RCHC Oshkosh",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.