NPIMap

Organization Active NPI

County of Grant

Doing business as Grant County Home Nursing

  • Home Health Agency
  • Lancaster, WI
National Provider Identifier
1710047923
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
57 Issued in WI
Legal business name
COUNTY OF GRANT
Doing business as
Grant County Home Nursing
Practice address
111 S Jefferson St FL 2
Lancaster, WI 53813-1672
Phone
(608) 723-6416
Fax
(608) 723-6501
NPI assigned
Dec 11, 2006
Last updated
Nov 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Authorized official

Name
Jeffery A Kindrai, MSPH, RS
Title
Director, Health Officer
Phone
(608) 723-6416

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 57 WI Primary

Addresses

Primary practice location

111 S Jefferson St FL 2
Lancaster, WI 53813-1672

Mailing address

111 S Jefferson St FL 2
Lancaster, WI 53813-1672
Phone (608) 723-6416

Other names 1

  • GRANT COUNTY HOME NURSING Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050411000405 WI Part A Provider - Home Health Agency 0244212959 Practice locations: Lancaster, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710047923. Details of each certification follow.

Home health agency certification: CCN 527027

Legal name
COUNTY OF GRANT
Doing business as
GRANT COUNTY HOME NURSING SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 1, 1966
Last certification
Feb 18, 2020
Ownership / control type
Government Operated
Organization structure
GovernmentNon-profit
Enrollment address
111 S Jefferson St
FL 2
Lancaster, WI 53813-1672
HHA Branch

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Grant County Home Nursing ServiceCCN 527027 · All quality measures
Overall star rating
2.5 of 5
Ownership
Government Operated
Certified
Jul 1, 1966
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Unified Board of Grant14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

111 S Jefferson St
Lancaster, WI 53813
Phone (608) 723-6416

111 S Jefferson St
Fl 2
Lancaster, WI 53813
Phone (608) 723-6416

Ownership & related parties

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.

NameRoleSinceShare
County of Grant Organization, Lancaster, WI Operational/Managerial Control Mar 22, 2005
Amy Miller Individual Corporate OfficerDirector Apr 7, 2014
Corporate DirectorDirector Apr 7, 2014
W-2 Managing EmployeeAd; Apr 7, 2014
Operational/Managerial ControlDirector Apr 7, 2014

Owners & managing parties with NPI records 4

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
Orchard Manor NorthLancaster, WI, CCN 525290 Skilled nursing facility 5% Or Greater Direct Ownership Interest
Operational/Managerial Control
Adp of the SNF		 Jan 1, 1976
Jan 1, 1976
Jan 1, 1976
County of GrantLancaster, WI, CCN 521540 Hospice Operational/Managerial Control (100%) Mar 22, 2005

Owned or controlled facilities with NPI records 2

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

  • County of Grant

    dba Orchard Manor Nursing Home

    • Skilled Nursing Facility
    • Lancaster, WI
    • NPI 1013904085

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • County of Grant

    dba Grant County Hospice

    • Community Based Hospice Care Agency
    • Lancaster, WI
    • NPI 1841359536

    Operational/Managerial Control

    CMS ownership

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226534400000",
    "number": "1710047923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S JEFFERSON ST FL 2",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538131672",
            "telephone_number": "608-723-6416",
            "fax_number": "608-723-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S JEFFERSON ST FL 2",
            "city": "LANCASTER",
            "state": "WI",
            "postal_code": "538131672",
            "telephone_number": "608-723-6416",
            "fax_number": "608-723-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF GRANT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2008-11-13",
        "status": "A",
        "authorized_official_last_name": "KINDRAI",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR, HEALTH OFFICER",
        "authorized_official_telephone_number": "608-723-6416",
        "authorized_official_credential": "MSPH, RS"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WI",
            "license": "57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRANT COUNTY HOME NURSING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, WI

Sources for this page

Verify at the official NPI Registry.