ST. JOSEPH'S HOME OF OUR LADY OF MT CARMEL INC
NPI 1740270735
Skilled Nursing Facility in Kenosha, WI

NPI Status: Active since October 21, 2005

Contact Information

9244 29TH AVE
KENOSHA, WI
ZIP 53143
Phone: (262) 694-0080
Fax: (262) 925-8137

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  • Organization
  • Skilled Nursing Facility
  • CLIA Number: 52D0723137
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 08-31-2026

About ST. JOSEPH'S HOME OF OUR LADY OF MT CARMEL INC

This page provides the complete NPI Profile along with additional information for St. Joseph's Home Of Our Lady Of Mt Carmel Inc, a provider established in Kenosha, Wisconsin operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1740270735 assigned on October 2005. The practitioner's primary taxonomy code is 314000000X with license number 2332 (WI). The provider is registered as an organization and their NPI record was last updated 15 years ago. The authorized official of this NPI record is Susie K Eidsor (Business Manager)

NPI
1740270735
Provider Name
ST. JOSEPH'S HOME OF OUR LADY OF MT CARMEL INC
Entity Type
Organization
Location Address
9244 29TH AVE KENOSHA, WI 53143
Location Phone
(262) 694-0080
Location Fax
(262) 925-8137
Mailing Address
9244 29TH AVE KENOSHA, WI 53143
Mailing Phone
(262) 694-0080
Mailing Fax
(262) 925-8137
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-21-2005
Last Update Date
08-11-2011
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
License No.
2332
License State
WI
Taxonomy Description
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SUSIE K EIDSOR

Authorized Official Title
BUSINESS MANAGER
Authorized Official Phone
(262) 925-8104

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
525603MEDICARE ID-TYPE UNSPECIFIED (04)WIMEDICARE PROVIDER NUMBER
20154500MEDICAID (05)WI 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
52D0723137
Facility Type
Assisted Living Facility
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
DR. KIERAN MCAVOY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to St. Joseph's Home Of Our Lady Of Mt Carmel Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for ST. JOSEPH'S HOME OF OUR LADY OF MT CARMEL INC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1740270735, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
4
Doubled → 8
Pos 4
0
Unchanged
Pos 5
2
Doubled → 4
Pos 6
7
Unchanged
Pos 7
0
Doubled → 0
Pos 8
7
Unchanged
Pos 9
3
Doubled → 6
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 2 → 4 0 → 0 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 8 + 0 + 4 + 7 + 0 + 7 + 6 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1740270735.

Other Providers at the Same Location


The following 11 providers are registered at the same or a nearby location.

Occupational Therapist
9244 29TH AVE
KENOSHA, WI 53143
Clinic/Center (Rehabilitation)
9244 29TH AVE, ATTN: THERAPY DEPT
KENOSHA, WI 53143
Occupational Therapist
9244 29TH AVE
KENOSHA, WI 53143
Physical Therapy Assistant
9244 29TH AVE
KENOSHA, WI 53143
Occupational Therapy Assistant
9244 29TH AVE
KENOSHA, WI 53143
Occupational Therapist
9244 29TH AVE
KENOSHA, WI 53143
Occupational Therapist
9244 29TH AVE
KENOSHA, WI 53143
Physical Therapist
9244 29TH AVE
KENOSHA, WI 53143
Nurse Practitioner (Adult Health)
9244 29TH AVE
KENOSHA, WI 53143
Occupational Therapy Assistant
9244 29TH AVE
KENOSHA, WI 53143
Physical Therapist
9244 29TH AVE
KENOSHA, WI 53143

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1740270735, enumerated as an "organization" on October 21, 2005.

The provider is located at 9244 29TH AVE KENOSHA, WI 53143 and the phone number is (262) 694-0080.

Skilled Nursing Facility with taxonomy code 314000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.