Childserve Homecare Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CHILDSERVE HOMECARE INC

Practice address

5406 Merle Hay Rd
Johnston, IA 50131-1209

Phone

(515) 727-8750

Fax

(515) 727-8757

NPI assigned

Feb 9, 2007

Last updated

Apr 18, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

CHILDSERVE INC.As reported in NPPES

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

Authorized official

Name

Rodney Wildrick

Title

Director of Accounting

Phone

(515) 727-1468

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780725960. Details of each certification follow.

• CCN 167286 Home health agency · Active · Details

Home health agency certification: CCN 167286

Legal name

CHILDSERVE HOMECARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 24, 1999

Last certification

Feb 13, 2019

Ownership / control type

Non-Profit

Organization structure

CorporationNon-profit

Incorporated

Apr 6, 1998 in IA

Enrollment address

5406 Merle Hay Rd
Johnston, IA 50131-1209

Listed as

Childserve Home Care IncCCN 167286 · All quality measures

Ownership

Non-Profit

Certified

Feb 24, 1999

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy

All disclosed owners & managing parties 6

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

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.

• Cody Campbell

  • Physical Therapy Assistant
  • Maryville, MO
  • NPI 1235676925
  NPD

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555545600000",
    "number": "1780725960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 707",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501310707",
            "telephone_number": "515-727-8750",
            "fax_number": "515-727-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5406 MERLE HAY RD",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311209",
            "telephone_number": "515-727-8750",
            "fax_number": "515-727-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDSERVE HOMECARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDSERVE INC.",
        "enumeration_date": "2007-02-09",
        "last_updated": "2019-04-18",
        "status": "A",
        "authorized_official_last_name": "WILDRICK",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "DIRECTOR OF ACCOUNTING",
        "authorized_official_telephone_number": "515-727-1468"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0672865",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IOWA",
            "identifier": "67286",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daisy Alejandra Cerna Poster
• Lorraine Chidester, APRN, PMHNP
• Childserve Community Options, Inc.
• Childserve Habilitation Center
• Childserve Habilitation Center Inc. (ChildServe Habilitation Center ICF/MR)
• Childserve Homes Inc. (ChildServe Homes SCL Waiver)
• Childserve Homes Inc. (ChildServe Stonecrest Home)
• Childserve Homes Inc. (ChildServe Morningside Home)
• Childserve Homes Inc. (ChildServe Johnston Home)
• Childserve Medical Equipment & Supply Inc.

• Home Health Agency in Johnston, IA
• Providers in Johnston, IA by specialty
• Home Health Agency in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; 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.