NPIMap

Organization Active NPI

Wesley at Home, LLC

  • Home Health Agency
  • Des Moines, IA
National Provider Identifier
1801080643
Registry record updated Apr 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 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
Last updated
Apr 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2014

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

Authorized official

Name
Mr. Cal Shelangoski
Title
Finance Director
Phone
(515) 271-6896

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X IA Primary
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 2

IdentifierTypeStateIssuer
0672956MedicaidIA
67295OtherIAWELLMARK BC/BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070822000574 IA Part A Provider - Home Health Agency 0547352502 Practice locations: Urbandale, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801080643. Details of each certification follow.

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
LLCNon-profit
Incorporated
Aug 7, 2007 in IA
Enrollment address
4328 114TH St
Urbandale, IA 50322-5408
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Wesley Life Home HealthCCN 167295 · All quality measures
Overall star rating
4 of 5
Ownership
Non-Profit
Certified
Sep 20, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D1028403Wesley at Home, LLC4328 114TH St, Urbandale, IA 50322Certificate of waiverJul 22, 2026

National Provider Directory

National Provider Directory
Tax ID family
Wesley at Home LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Chad Rasmussen Individual Corporate Director Jun 1, 2007
Rochelle a Carver Individual Operational/Managerial Control Aug 6, 2020
Daniel W Reneker Individual Corporate Director Jun 1, 2007
Robert William Kretzinger Individual Corporate Director Jun 1, 2007
W-2 Managing Employee Jun 1, 2007
Nicholas Harshfield Individual Corporate Officer Oct 16, 2017
Susan Watson Individual Corporate Director Jan 1, 2014
Kirk J Tyler Individual Corporate Director Jun 1, 2007
Joanne Lorence Individual Corporate Director Jun 1, 2007
Nicole Lynn Hoeksema Individual Corporate DirectorDirector of Reimbursement Mar 1, 2021
David B Stout Individual Corporate Director Jun 1, 2007
Wesleylife Organization, Johnston, IA Non-profit 5% Or Greater Direct Ownership Interest Sep 21, 2010 100%
Operational/Managerial Control Sep 1, 2007 60%
Wesley Community Services Inc Organization, Des Moines, IA Non-profit Operational/Managerial Control Sep 1, 2007 40%
Robert M. Ruch Individual Corporate DirectorBoard of Director Jan 1, 2011
John F. Moenck Individual Corporate Director Jun 1, 2007

Owners & managing parties with NPI records 3

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

Facilities with the same owner 11

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

Practitioners & affiliated clinicians

Affiliated clinicians 64

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

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398643200000",
    "number": "1801080643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5508 NW 88TH STREET",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501313005",
            "telephone_number": "515-271-6789",
            "fax_number": "515-271-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "944 18TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503141152",
            "telephone_number": "515-288-3334",
            "fax_number": "515-288-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY AT HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2014-04-28",
        "status": "A",
        "authorized_official_last_name": "SHELANGOSKI",
        "authorized_official_first_name": "CAL",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "515-271-6896",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IA",
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0672956",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC/BS",
            "identifier": "67295",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.