Wesley at Home, LLC
Organization Active NPI Home Health Agency · Des Moines, IA
NPI 1801080643 · NPPES record last updated Apr 28, 2014
Key facts
- NPI
- 1801080643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- WESLEY AT HOME, LLC
- Practice address
- 944 18TH St
Des Moines, IA 50314-1152 - Phone
- (515) 288-3334
- Fax
- (515) 288-4740
- NPI assigned
- Sep 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Cal Shelangoski
- Title
- Finance Director
- Phone
- (515) 271-6896
Owners & managing parties with NPI records 3
Corporate family (same tax ID) 1
Member of 1
Facilities with the same owner 11
Affiliated clinicians 64
-
Jennifer M Abler, D.O.
-
Michael Agey, DO
-
Kawsu Barry, MD
-
Mitchell Lee Blom, D.O.
-
Rebecca Bollin, DO
-
Ailey Brehmer, DO
-
Tze Y. Chan, DO
-
Arthur P Check, DO
-
Kevin James Cunningham, M.D.
-
Sean D Cunningham, M.D.
-
Susan Louise Donahue, D.O.
-
Danney Paul Drewry, D.O
-
Carole A Frier, D.O.
-
Sarah Ann Garner, MD
Medicare Care Compare: Home health agency
- Listed as
- Wesley Life Home Health
- Overall star rating
- ★★★★☆ 4 of 5
- Ownership
- Non-Profit
- Certified
- Sep 20, 2004
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D1028403 | Wesley at Home, LLC | Certificate of waiver | Jul 22, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Home health agency certification: CCN 167295
- Legal name
- WESLEY AT HOME LLC
- Doing business as
- WESLEYLIFE HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Sep 20, 2004
- Last certification
- Feb 27, 2020
- Ownership / control type
- Non-Profit
- Organization structure
- LLC · Non-profit
- Incorporated
- Aug 7, 2007 in IA
- Enrollment address
- 4328 114TH St
Urbandale, IA 50322-5408
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Chad Rasmussen |
Corporate Director | Jun 1, 2007 | |
| Rochelle a Carver |
Operational/Managerial Control | Aug 6, 2020 | |
| Daniel W Reneker |
Corporate Director | Jun 1, 2007 | |
| Robert William Kretzinger |
Corporate Director | Jun 1, 2007 | |
| W-2 Managing Employee | Jun 1, 2007 | ||
| Nicholas Harshfield |
Corporate Officer | Oct 16, 2017 | |
| Susan Watson |
Corporate Director | Jan 1, 2014 | |
| Kirk J Tyler |
Corporate Director | Jun 1, 2007 | |
| Joanne Lorence |
Corporate Director | Jun 1, 2007 | |
| Nicole Lynn Hoeksema |
Corporate Director |
Mar 1, 2021 | |
| David B Stout |
Corporate Director | Jun 1, 2007 | |
| Wesleylife |
5% Or Greater Direct Ownership Interest | Sep 21, 2010 | 100% |
| Operational/Managerial Control | Sep 1, 2007 | 60% | |
| Wesley Community Services Inc |
Operational/Managerial Control | Sep 1, 2007 | 40% |
| Robert M. Ruch |
Corporate Director |
Jan 1, 2011 | |
| John F. Moenck |
Corporate Director | Jun 1, 2007 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070822000574 | IA | Part a Provider - Home Health Agency | 0547352502 | Practice locations: Urbandale, IA |
National Provider Directory
- Tax ID family
- Wesley at Home LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | IA | Yes | |
| Home Health Agency | 251E00000X |
Addresses
Primary practice location
944 18TH St
Des Moines, IA 50314-1152
Mailing address
5508 NW 88TH Street
Johnston, IA 50131-3005
Phone (515) 271-6789
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0672956 | Medicaid | IA | |
| 67295 | Other | IA | WELLMARK BC/BS |
Other providers in Des Moines, IA
- Amanda Lyne Wentworth-Puentes
- Kaitlyn Werkmeister
- Kara Werth
- Monica D Wescott
- Wesley at Home LLC
- Wesley Community Services
- Wesley Community Services, Inc.
- Wesley Retirement Services, Inc.
- Jacob Nelson Wesselink
- Amy West
All providers in Des Moines, IA · Home Health Agency in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.