NPIMap

Organization Active NPI

Tabitha, Inc.

Doing business as Tabitha Home Health Care

  • Home Health Agency
  • Lincoln, NE
National Provider Identifier
1720163298
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
501017 Issued in NE
Legal business name
TABITHA, INC.
Doing business as
Tabitha Home Health Care
Practice address
4720 Randolph Street
Lincoln, NE 68510-3741
Phone
(402) 483-7671
Fax
(402) 486-8539
NPI assigned
Oct 25, 2006
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
Home Health Agency 251E00000X 501017 NE Primary

Addresses

Primary practice location

4720 Randolph Street
Lincoln, NE 68510-3741

Mailing address

4720 Randolph St
Lincoln, NE 68510-3741

Other names 1

  • Tabitha Home Health Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040310000134 NE Part A Provider - Home Health Agency 3274421284 Practice locations: Grand Island, NE; York, NE; Lincoln, NE
O20050201000661 NE Part B Supplier - Clinic/Group Practice 3274421284 Receives reassigned benefits from 1 practitioner
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Franklin, NE; Holdrege, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720163298. Details of each certification follow.

Home health agency certification: CCN 287002

Legal name
TABITHA, INC.
Doing business as
EVENTIDE HOME HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 1, 1966
Last certification
Nov 14, 2018
Ownership / control type
Proprietary
Organization structure
CorporationNon-profit
Enrollment address
4720 Randolph St
Lincoln, NE 68510-3741

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Eventide Home Health CareCCN 287002 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Jul 1, 1966
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

4720 Randolph St
Lincoln, NE 68510
Phone (402) 483-7671

Ownership & related parties

All disclosed owners & managing parties 17

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 Officer 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 5% Or Greater Indirect Ownership Interest Oct 10, 2024 100%
Darin G Ohe Individual Operational/Managerial ControlCfo Oct 10, 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
Eventide Organization, Moorhead, MN Corporation, Non-profit, Chain home office Operational/Managerial Control Oct 10, 2024 100%
Judith Lee Individual Corporate Director Oct 10, 2024
Charity M Ebert Individual W-2 Managing EmployeeAdministrator Nov 1, 2022
Operational/Managerial ControlAdministrator Nov 1, 2022
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 2

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

  • Eventide
    • Assisted Living Facility
    • Moorhead, MN
    • NPI 1487705653

    Operational/Managerial Control

    CMS ownership
  • Eventide
    • Skilled Nursing Facility
    • West Fargo, ND
    • NPI 1942538608

    Operational/Managerial Control

    CMS ownership

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 109

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

View all 109

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1720163298",
    "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": "4720 RANDOLPH STREET",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685103741",
            "telephone_number": "402-483-7671",
            "fax_number": "402-486-8539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABITHA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "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": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NE",
            "license": "501017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tabitha Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tabitha Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.