Goodwill Healthcare Services, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GOODWILL HEALTHCARE SERVICES, INC

Practice address

21906 Rustic Canyon LN
Richmond, TX 77469-5445

Phone

(346) 368-2168

Fax

(832) 553-7615

NPI assigned

Jul 16, 2012

Organization subpart

No

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

Authorized official

Name

Isioma Ozonoh

Title

Administrator

Phone

(346) 368-2168

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Home health agency certification: CCN 747932

Legal name

GOODWILL HEALTHCARE SERVICES, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 14, 2014

Last certification

May 6, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jul 16, 2012 in TX

Enrollment address

21906 Rustic Canyon Lane
Richmond, TX 77469-5445

Listed as

Goodwill Healthcare Services IncCCN 747932 · All quality measures

Ownership

Proprietary

Certified

Feb 14, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

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 1

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

• Osadebamwen Omoregie

  • Psychiatric/Mental Health Nurse Practitioner
  • Tacoma, WA
  • NPI 1336798974

  Corporate Director, W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Osadebamwen Omoregie

  • Psychiatric/Mental Health Nurse Practitioner
  • Tacoma, WA
  • NPI 1336798974
  NPD (past)

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1184979122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21906 RUSTIC CANYON LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774695445",
            "telephone_number": "346-368-2168",
            "fax_number": "832-553-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21906 RUSTIC CANYON LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774695445",
            "telephone_number": "346-368-2168",
            "fax_number": "832-553-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL HEALTHCARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-16",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "OZONOH",
        "authorized_official_first_name": "ISIOMA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "346-368-2168"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Armie Gonzalez
• Leyanis Gonzalez, APRN-FNP
• Teddy Gonzalez, MD
• Good Faith Seniors Homecare
• Rachel Goodman, OT
• Goodwill Medical Supplies LLC
• Dipika Goradia
• Micaela N Gordon, FNP
• Katherine Elizabeth Gort, OTR
• Goshen Comfort Home Inc.

• Home Health Agency in Richmond, TX
• Providers in Richmond, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.