Good Neighbor Home Health Care of Brainerd, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GOOD NEIGHBOR HOME HEALTH CARE OF BRAINERD, INC.

Practice address

14387 Edgewood Dr
Baxter, MN 56425-8460

Phone

(218) 829-9238

Fax

(218) 829-2144

NPI assigned

Jul 7, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Sara Michelle Sundberg

Title

Cfo

Phone

(218) 829-9238

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Home health agency certification: CCN 247269

Legal name

GOOD NEIGHBOR HOME HEALTH CARE OF BRAINERD, INC.

Doing business as

GOOD NEIGHBOR HOME HEALTH CARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 19, 1992

Last certification

May 9, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Apr 13, 1992 in MN

Enrollment address

7111 Forthun Rd
Ste 100
Baxter, MN 56425-8596
HHA Branch

Listed as

Good Neighbor HHC of BrainerdCCN 247269

Overall star rating

2.5 of 5

Ownership

Proprietary

Certified

Jun 19, 1992

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Occupational therapy

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

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

Affiliated clinicians 1

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

• Tyler John Dunphy, MD

  • Internal Medicine Physician
  • Brainerd, MN
  • NPI 1164684320

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1841297769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 481",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564010481",
            "telephone_number": "218-829-9238",
            "fax_number": "218-829-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14387 EDGEWOOD DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258460",
            "telephone_number": "218-829-9238",
            "fax_number": "218-829-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD NEIGHBOR HOME HEALTH CARE OF BRAINERD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "SUNDBERG",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "218-829-9238",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7742550-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jody Ann Giza, PA-C
• Alexis Lynn Glomski, DO
• Joshua Goemaat
• Laura Anne Goll
• Good Neighbor Resources, Inc.
• Grand St Paul CVS LLC
• Brittany Jo Grater
• Great Lakes Injury Center, PLLC
• Greatlakes Injury Center

• Home Health Agency in Baxter, MN
• Providers in Baxter, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.