Oakridge Homes of Wadena, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

151545400 Issued in MN

Legal business name

OAKRIDGE HOMES OF WADENA, INC.

Practice address

1021 Industrial Park Road
Brainerd, MN 56401-8338

Phone

(218) 829-7599

Fax

(218) 829-7498

NPI assigned

Apr 25, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Jason Leigh Forbord, CPA

Title

Controller

Phone

(218) 829-7599

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Shawna Jo Wippler, CPRP

  • Mental Health Counselor
  • Brainerd, MN
  • NPI 1881085132
  NPD (past)

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1710152202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 INDUSTRIAL PARK RD SW",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564018338",
            "telephone_number": "218-829-7599",
            "fax_number": "218-829-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 INDUSTRIAL PARK ROAD",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564018338",
            "telephone_number": "218-829-7599",
            "fax_number": "218-829-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKRIDGE HOMES OF WADENA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "FORBORD",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "218-829-7599",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "MN",
            "license": "151545400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VENDOR NUMBER",
            "identifier": "066943021",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER LICENSE NUMBER",
            "identifier": "151545400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Norwood, MASTER OF ARTS, LPCC
• Robert Scott Nystrom, R.PH.
• Michael Charles O'Day, D.C.
• James J O'Hearn
• Robert O'Neill
• Oakridge Support Services, Inc
• Kathy Margaret Ogden
• Ol-US Brainerd, LLC
• Ted W Olds, M.D.
• Aimee Jean Olsen, RN

• Intellectual Disabilities Intermediate Care Facility in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Intellectual Disabilities Intermediate Care Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.