Bethel Home, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2005 Issued in WI

Legal business name

BETHEL HOME, INC.

Practice address

225 N Eagle St
Oshkosh, WI 54902-4125

Phone

(920) 235-4653

Fax

(920) 235-2771

NPI assigned

Apr 10, 2006

Last updated

Jul 28, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Richard A. Kern, BBA, MBA, CPA

Title

Cfo/Treasurer

Phone

(920) 232-5220

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124081229. Details of each certification follow.

• CCN 525554 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 525554

Legal name

BETHEL HOME, INC.

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 1, 1994

Last certification

Aug 7, 2024

Beds

100

Ownership / control type

Nonprofit Corporation

Multi-facility organization

Miravida Living

Organization structure

CorporationNon-profit

Incorporated

Jan 25, 1974 in WI

Enrollment address

225 N Eagle St
Oshkosh, WI 54902-4125

Nursing home name

BETHEL HOME

Listed as

Bethel HomeCCN 525554 · All quality measures

Overall star rating

5 of 5

Health inspections

4 of 5

Staffing

5 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Dec 1, 1994

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10061.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Miravida Living Inc

  dba Lho Pharmacy LLC

  • Long Term Care Pharmacy
  • Oshkosh, WI
  • NPI 1700874591

  Member Of

  NPD member

All disclosed owners & managing parties 11

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

Owners & managing parties with NPI records 2

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

• Miravida Living Inc

  dba Lho Pharmacy LLC

  • Long Term Care Pharmacy
  • Oshkosh, WI
  • NPI 1700874591

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• Laurie L Muller, MD

  • Pediatrics Physician
  • Oshkosh, WI
  • NPI 1962496869

  Corporate Director

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Kelsey Kienert, M.D.

  • Internal Medicine Physician
  • Neenah, WI
  • NPI 1134501190

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280275200000",
    "number": "1124081229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N EAGLE ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549024125",
            "telephone_number": "920-235-4653",
            "fax_number": "920-235-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N EAGLE ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549024125",
            "telephone_number": "920-235-4653",
            "fax_number": "920-235-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2010-07-28",
        "status": "A",
        "authorized_official_last_name": "KERN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CFO/TREASURER",
        "authorized_official_telephone_number": "920-232-5220",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BBA, MBA, CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20127400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Berghammer, ATS
• Kimberly Jean Berndt, M.S., OTR
• Robert L Bernstein, MD
• Barbara A Berres, PT
• Caden Berry
• Telene Darice Bettcher, PHARM.D.
• Danielle Bettine
• Abigail Beyer, RBT
• Srinivas Bhadriraju, M.D.
• Cole Biechler, CRNA

• Skilled Nursing Facility in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; 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.

Verify at the official NPI Registry.