Omni Home Healthcare Incorporated

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

OMNI HOME HEALTHCARE INCORPORATED

Doing business as

Omni Personal Care Incorporated

Practice address

12201 W North Ave
Suite 101
Wauwatosa, WI 53226-2061

Phone

(414) 204-8462

Fax

(262) 342-2673

NPI assigned

May 11, 2017

Last updated

May 11, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kiante Shields

Title

Administrative Director

Phone

(414) 213-6335

Specialties & licenses 1

Addresses

Other names 1

• Omni Personal Care Incorporated Doing business as

Locations

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1942736947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 W NORTH AVE",
            "address_2": "SUITE 101",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262061",
            "telephone_number": "414-204-8462",
            "fax_number": "262-342-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 W NORTH AVE",
            "address_2": "SUITE 101",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262061",
            "telephone_number": "414-204-8462",
            "fax_number": "262-342-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI HOME HEALTHCARE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "KIANTE",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "414-213-6335"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omni Personal Care Incorporated",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.