Active NPI
Kismet RDK, LLC
Doing business as WEL-Home Health of Red Oak
- Home Health Agency
- Red Oak, IA
National Provider Identifier
1306829411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- KISMET RDK, LLC
- Doing business as
- WEL-Home Health of Red Oak
- Practice address
- 1600 E Summit St
Red Oak, IA 51566-1709 - Phone
- (712) 623-2500
- NPI assigned
- Nov 22, 2005
- Last updated
- Jan 8, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael L. Moore
- Title
- Chief Financial Officer
- Phone
- (605) 642-7736
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
1600 E Summit St
Red Oak, IA 51566-1709
Mailing address
1600 E Summit St
Red Oak, IA 51566-1709
Phone (712) 623-2500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0672832 | Medicaid | IA |
Other names 1
- WEL-Home Health of Red Oak
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190312002619 | IA | Part A Provider - Home Health Agency | 4587912712 | Practice locations: Red Oak, IA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1306829411. Details of each certification follow.
Home health agency certification: CCN 167282
- Legal name
- KISMET RDK, LLC
- Doing business as
- WEL HOME HEALTH RED OAK
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- May 5, 1998
- Last certification
- Jun 5, 2019
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Incorporated
- Jun 6, 2018 in IA
- Enrollment address
- 1600 E Summit St
Red Oak, IA 51566-1709
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Red Oak Rehab and Care Center
- Skilled Nursing Facility
- Red Oak, IA
- NPI 1255332557
4587912712
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Wel-Home Health of Red Oak
- Overall star rating
- Ownership
- Proprietary
- Certified
- May 5, 1998
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D0924486 | Wel-Home Health Red Oak | Certificate of waiver | Dec 6, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 10
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Lantis Enterprises, Inc | Operational/Managerial Control | Sep 1, 2018 | |
| Sandra Leah Rinard | Contracted Managing Employee | Sep 1, 2018 | 12% |
| 5% Or Greater Direct Ownership Interest | Sep 1, 2018 | 12% | |
| Operational/Managerial Control | Sep 1, 2018 | 12% | |
| Stephanie Wood | W-2 Managing Employee | Sep 1, 2018 | |
| Kismet Holdings LLC | 5% Or Greater Indirect Ownership Interest | Sep 1, 2018 | 100% |
| Kismet HD LLC | 5% Or Greater Indirect Ownership Interest | Jan 23, 2024 | 100% |
| Mary Ellen Lantis | Contracted Managing Employee | Sep 1, 2018 | 52% |
| 5% Or Greater Direct Ownership Interest | Sep 1, 2018 | 52% | |
| Operational/Managerial Control | Sep 1, 2018 | 52% | |
| Michael Leslie Moore | Contracted Managing Employee | Sep 1, 2018 | |
| Operational/Managerial Control | Sep 1, 2018 | ||
| Travis W Lantis | Contracted Managing Employee | Sep 1, 2018 | 12% |
| 5% Or Greater Direct Ownership Interest | Sep 1, 2018 | 12% | |
| Operational/Managerial Control | Sep 1, 2018 | 12% | |
| Wendy L Soulek | Contracted Managing Employee | Sep 1, 2018 | 12% |
| 5% Or Greater Direct Ownership Interest | Sep 1, 2018 | 12% | |
| Operational/Managerial Control | Sep 1, 2018 | 12% | |
| Cammy S Lantis | Contracted Managing Employee | Sep 1, 2018 | 12% |
| 5% Or Greater Direct Ownership Interest | Sep 1, 2018 | 12% | |
| Operational/Managerial Control | Sep 1, 2018 | 12% |
Facilities with the same owner 5
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Red Oak Rehab and Care Center
- Skilled Nursing Facility
- Red Oak, IA
- NPI 1255332557
Lantis Enterprises, Inc
-
dba WEL-Home Health Sergeant Bluff
- Home Health Agency
- Sergeant Bluff, IA
- NPI 1437131216
Kismet HD LLC, Kismet Holdings LLC, Lantis Enterprises, Inc
-
dba Embassy Rehab and Care Center
- Skilled Nursing Facility
- Sergeant Bluff, IA
- NPI 1457359200
Lantis Enterprises, Inc
-
dba Crest View Healthcare Community
- Skilled Nursing Facility
- Chadron, NE
- NPI 1932107711
Lantis Enterprises, Inc
-
dba Falls City Care Center
- Skilled Nursing Facility
- Falls City, NE
- NPI 1740280437
Lantis Enterprises, Inc
Change-of-ownership history 2
| Date | Event | Counterparty |
|---|---|---|
| Sep 1, 2018 | Change of Ownership | Welcov Home Health of Red Oak |
| Sep 1, 2018 | Change of Ownership | Wel Home Health Red Oak |
Practitioners & affiliated clinicians
Affiliated clinicians 9
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1546905600000",
"number": "1306829411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 E SUMMIT ST",
"city": "RED OAK",
"state": "IA",
"postal_code": "515661709",
"telephone_number": "712-623-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 E SUMMIT ST",
"city": "RED OAK",
"state": "IA",
"postal_code": "515661709",
"telephone_number": "712-623-2500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KISMET RDK, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-22",
"last_updated": "2019-01-08",
"status": "A",
"authorized_official_last_name": "MOORE",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "605-642-7736"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0672832",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "WEL-Home Health of Red Oak",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Red Oak, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.