Gemini Holdings, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

GEMINI HOLDINGS, LLC

Practice address

910 Bear Paw Ave
Rice Lake, WI 54868-1388

Phone

(715) 234-2604

NPI assigned

Apr 13, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Tommy L Davidson

Title

Chief Manager

Phone

(423) 910-1116

Specialties & licenses 1

Addresses

Other names 1

• Dove Healthcare - Rice Lake Doing business as

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469664000000",
    "number": "1164876397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7429 ROYAL HARBOUR CIR",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373639151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BEAR PAW AVE",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681388",
            "telephone_number": "715-234-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEMINI HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-13",
        "last_updated": "2016-07-28",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "423-910-1116",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dove Healthcare - Rice Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kate S Flood, PA-C
• Alexandria Lynn Fox, DNP
• Elizabeth Fox
• Susan J Frazier, MD
• Pradeep Gade
• Thomas G Gerber Jr., MD
• Jonathan Ryan Gilbert, DPT
• Sharon K Gjerde, PT
• Donna L Glaser, LPC, LCPC
• Dorian L Glaze, CCC-SLP

• Skilled Nursing Facility in Rice Lake, WI
• Providers in Rice Lake, 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, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.