NPIMap

Organization Active NPI

Tabitha, Inc.

Doing business as Tabitha at the Landing

  • Skilled Nursing Facility
  • Lincoln, NE
National Provider Identifier
1699100214
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
TABITHA, INC.
Doing business as
Tabitha at the Landing
Practice address
6120 South 34TH Street
Lincoln, NE 68516
Phone
(402) 483-7671
Fax
(402) 486-8539
NPI assigned
Sep 13, 2013
Last updated
Dec 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Renae Endicott
Title
Assistant Director of Finance
Phone
(402) 484-9711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

6120 South 34TH Street
Lincoln, NE 68516

Mailing address

4720 Randolph St
Lincoln, NE 68510-3741

Other names 1

  • TABITHA AT THE LANDING Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131127001388 NE Part A Provider - Skilled Nursing Facility 3274421284 Practice locations: Lincoln, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699100214. Details of each certification follow.

Skilled nursing facility certification: CCN 285288

Legal name
TABITHA, INC.
Doing business as
EVENTIDE WILLIAMSBURG
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 2, 2014
Last certification
Nov 21, 2024
Beds
50
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Tabitha Inc
Organization structure
CorporationNon-profit
Enrollment address
6120 S 34TH St
Lincoln, NE 68516-4748
Nursing home name
EVENTIDE WILLIAMSBURG

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Eventide WilliamsburgCCN 285288 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
May 2, 2014
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5026.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Tabitha Health Care Ser10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6100 S 34th St
Lincoln, NE 68516

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Jon M Riewer Individual Corporate OfficerPresident & Ceo Oct 10, 2024
Karla Swenson Individual Corporate Director Oct 10, 2024
Eric Schafer Individual Corporate Director Jan 1, 2013
Eventide Nebraska Senior Living LLC Organization, Moorhead, MN LLC, Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 10, 2024 100%
Darin G Ohe Individual Operational/Managerial Control Nov 22, 2024
Robert J Bye Individual Corporate Officer Oct 10, 2024
Corporate Director Oct 10, 2024
Peter J Seljevold Individual Corporate Director Oct 10, 2024
Brandon Lunak Individual Corporate OfficerTreasurer Apr 1, 2026
Corporate Director Oct 10, 2024
Tyler Fischbach Individual Corporate Director Oct 10, 2024
Jodee Bock Individual Corporate Director Oct 10, 2024
Patrick Gulbranson Individual Corporate Director Oct 10, 2024
Terry Brandt Individual Corporate Director Oct 10, 2024
Alisa J Nollendorfs Individual Adp of the SNF Apr 10, 2026
Eventide Organization, Moorhead, MN Corporation, Non-profit, Chain home office Operational/Managerial Control Dec 18, 2024
Kelsie Ryan Individual Operational/Managerial Control Feb 18, 2018
Adp of the SNF Apr 13, 2026
Judith Lee Individual Corporate Director Oct 10, 2024
Cindy Larson-Casselton Individual Corporate Director Oct 10, 2024
Vikki Johnson Individual Corporate Officer Oct 10, 2024
Corporate Director Oct 10, 2024

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Eventide Prairie Commons Care CenterGrand Island, NE, CCN 285307 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 22, 2022
Tabitha Hospice-a Collaboration With ImmanuelOmaha, NE, CCN 281556 Hospice 5% Or Greater Direct Ownership Interest (75%) Dec 13, 2021

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 12

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1699100214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 RANDOLPH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685103741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 SOUTH 34TH STREET",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68516",
            "telephone_number": "402-483-7671",
            "fax_number": "402-486-8539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABITHA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "ENDICOTT",
        "authorized_official_first_name": "RENAE",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "402-484-9711"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TABITHA AT THE LANDING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.