Outreach Homehealth Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

OUTREACH HOMEHEALTH SERVICES, INC.

Practice address

1123 7TH Ave
Suite 3
Rock Island, IL 61201-8449

Phone

(309) 786-3541

Fax

(309) 786-4573

NPI assigned

Jan 8, 2009

Organization subpart

Yes

Parent organization

OUTREACH HOMEHEALTH SERVICES, INC.As reported in NPPES

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

Authorized official

Name

Mr. Uche Mbakwe

Title

Ceo

Phone

(309) 786-3541

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

Outreach Homehealth Services Inc

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• JKCD Healthcare Consulting, LLC

  • Home Health Agency
  • Moline, IL
  • NPI 1184150419

  Sold to, 2019-01-28

  CMS change of ownership

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1922245224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 7TH AVE",
            "address_2": "SUITE 3",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612018449",
            "telephone_number": "309-786-3541",
            "fax_number": "309-786-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 7TH AVE",
            "address_2": "SUITE 3",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612018449",
            "telephone_number": "309-786-3541",
            "fax_number": "309-786-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTREACH HOMEHEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OUTREACH  HOMEHEALTH SERVICES, INC.",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "MBAKWE",
        "authorized_official_first_name": "UCHE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-786-3541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1447200027",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1093995458",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Occupational Health Centers of Illinois, P.C.
• Occupational Health Centers of Illinois, P.C.
• Occupational Health Centers of Illinois, P.C.
• Valerie S Olson, LCPC
• Ora Orthopedics PC
• Outreach Medical, Inc.
• Gloria Pagan, MS CCC-SLP
• Sanjay Suryakant Pancholi, D.O.
• Caleb Paniamogan, DO
• Kerry P Panozzo, MD

• Home Health Agency in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.