Omro Nursing and Rehab, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

OMRO NURSING AND REHAB, LLC

Practice address

500 Grant Ave
Omro, WI 54963-1342

Phone

(920) 685-2755

NPI assigned

Nov 12, 2018

Last updated

Sep 16, 2020By 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

Pamela Rice

Title

Director of Revenue

Phone

(847) 712-8901

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467920017. Details of each certification follow.

• CCN 525406 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 525406

Legal name

OMRO NURSING AND REHAB LLC

Doing business as

OMRO CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 1, 1987

Last certification

Jul 24, 2024

Beds

50

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Eden Senior Care

Organization structure

LLCProprietary

Incorporated

Oct 18, 2018 in WI

Enrollment address

500 Grant Ave
Omro, WI 54963-1342

Nursing home name

EDENBROOK OMRO

Affiliated entity

EDEN SENIOR CARE

Listed as

Edenbrook OmroCCN 525406 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

2 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Mar 1, 1987

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5033.4 residents per day on average

Chain

Eden Senior Care21 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 8

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

Affiliated clinicians 1

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

• Jeffrey Allen Farvour, MD

  • Family Medicine Physician
  • Oshkosh, WI
  • NPI 1669931978

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1467920017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD STE 112",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762914",
            "telephone_number": "773-825-3336",
            "fax_number": "773-570-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GRANT AVE",
            "city": "OMRO",
            "state": "WI",
            "postal_code": "549631342",
            "telephone_number": "920-685-2755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMRO NURSING AND REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-12",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE",
        "authorized_official_telephone_number": "847-712-8901"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah A Olson, NP
• Omro Chiropractic Center
• Omro Chiropractic Office, SC
• Omro Healthcare LLC (Omro Care Center)
• Omro Meds, LLC (Omro Meds)
• Kristin Anne Phillips, PHARMD
• Primal Chiropractic Omro LLC
• Madelin Pulvermacher, DNP-FNP
• David E Resen, MD
• Lynn M Roelke, RN

• Skilled Nursing Facility in Omro, WI
• Providers in Omro, 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 Sep 16, 2020; 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.