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

Active since October 21, 2005CLIA 52D0723137 · Waiver
9244 29TH AVE, KENOSHA, WI 53143(262) 694-0080(262) 925-8137 Get Directions Write a Review

NPPES record last updated: August 11, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About St. Joseph's Home Of Our Lady Of Mt Carmel Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST. JOSEPH'S HOME OF OUR LADY OF MT CARMEL INC (NPI 1740270735) is a healthcare organization registered as a skilled nursing facility in Kenosha, Wisconsin and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Susie K Eidsor, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1740270735
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameST. JOSEPH'S HOME OF OUR LADY OF MT CARMEL INC
Location Address9244 29TH AVEKenosha, WI 53143-6602
Mailing Address9244 29th AveKenosha, WI 53143-6602 · (262) 694-0080 · Fax (262) 925-8137
Phone(262) 694-0080
Fax(262) 925-8137
Organization SubpartNo
Authorized OfficialSusie K EidsorBusiness Manager · (262) 925-8104
Enumeration DateOctober 21, 2005
Last NPPES UpdateAugust 11, 2011
✔ NPI 1740270735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License✔ Licensed in WI · 2332
Definition
(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.
9244 29TH AVE, Kenosha, WI 53143
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Other Identifiers 2

Medicare ID-Type Unspecified525603WI · Medicare Provider Number
Medicaid20154500WI

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D0723137

St Joseph's Home Of Our Lady Of Mt Carmel, Inc · Kenosha, WI
Active · expires Aug 31, 2026
CLIA Number52D0723137
Laboratory TypeAssisted Living Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDr. Kieran Mcavoy
Laboratory Phone(262) 694-0080
Laboratory LocationSt Joseph's Home Of Our Lady Of Mt Carmel, Inc9244 29th Avenue, Kenosha, WI 53143
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. TINA M HEEBSH COTA
Occupational Therapy Assistant
9244 29TH AVE
KENOSHA, WI 53143
Kenosha County (262) 694-0080
LORI ANN FREISINGER OTR
Clinic/Center (Rehabilitation)
9244 29TH AVE, ATTN: THERAPY DEPT
KENOSHA, WI 53143
Kenosha County (262) 694-0080
KATHLEEN JEANEEN SUMMERS NURSE PRACTITIONER
Nurse Practitioner (Adult Health)
9244 29TH AVE
KENOSHA, WI 53143
Kenosha County (262) 694-0080
MRS. SANDRA LEE JONAS O.T.
Occupational Therapist
9244 29TH AVE
KENOSHA, WI 53143
Kenosha County (262) 694-0080
SARAH GYURINA OTR
Occupational Therapist
9244 29TH AVE
KENOSHA, WI 53143
Kenosha County (262) 694-0080
TERESE NADBORALSKI
Occupational Therapist
9244 29TH AVE
KENOSHA, WI 53143
Kenosha County (262) 694-0080
MR. COLLIN SCOTT BARBER
Physical Therapist
9244 29TH AVE
KENOSHA, WI 53143
Kenosha County (262) 694-0080
MS. SARAH ANN DOSEMAGEN PTA
Physical Therapy Assistant
9244 29TH AVE
KENOSHA, WI 53143
Kenosha County (262) 694-0080

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St. Joseph's Home Of Our Lady Of Mt Carmel Inc's NPI number?

The NPI number for St. Joseph's Home Of Our Lady Of Mt Carmel Inc is 1740270735. It was assigned to this organization in the NPPES registry on October 21, 2005.

Where is St. Joseph's Home Of Our Lady Of Mt Carmel Inc located?

St. Joseph's Home Of Our Lady Of Mt Carmel Inc is located at 9244 29th Ave, Kenosha, WI 53143. The listed phone number is (262) 694-0080.

What is St. Joseph's Home Of Our Lady Of Mt Carmel Inc's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does St. Joseph's Home Of Our Lady Of Mt Carmel Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0723137) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for St. Joseph's Home Of Our Lady Of Mt Carmel Inc was last updated on August 11, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.