GEMINI HOLDINGS, LLC (NPI# 1164876397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164876397 |
| Entity Type | Organization |
| Organization Name | GEMINI HOLDINGS, LLC |
| Other Organization Name | DOVE HEALTHCARE - RICE LAKE |
| Practice Address |
910 Bear Paw Ave Rice Lake WI 54868-1388 |
| Mailing Address |
7429 Royal Harbour Cir Ooltewah TN 37363-9151 |
| Practice Telephone | 7152342604 |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2016-07-28 |
| Authorized Official Name | MR. TOMMY L DAVIDSON (CHIEF MANAGER) |
| Authorized Official Telephone | 4239101116 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | WI | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Dove Healthcare - Rice Lake | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | GEMINI HOLDINGS, LLC | 301 Sw Hickory Glen, Grimes, IA 50111 |
| Colorado Business Entities | Gemini Holdings, LLC | 400 E. Third Ave., #504, Denver, CO 80203 |
| Vermont Business Registrations | GEMINI HOLDINGS, LLC | 1263 Dog Team Rd, New Haven, VT 05472 |
| Washington State Corporations | GEMINI HOLDINGS, LLC | 563 Lk Wash Blvd E, Seattle, WA 98112 |
| Street Address |
910 BEAR PAW AVE |
| City | RICE LAKE |
| State | WI |
| Zip Code | 54868-1388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164975017 | Adrianne Sullivan | Physical Therapy Assistant | 910 Bear Paw Ave, Rice Lake, WI 54868-1388 | 2016-07-27 |
| 1518410463 | Reisa Renee Hilbert | Physical Therapy Assistant | 910 Bear Paw Ave, Rice Lake, WI 54868-1388 | 2016-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073170791 | Samantha Barg | Physical Therapist | 1035 N. Main Street, Rice Lake, WI 54868 | 2019-05-29 |
| 1023597531 | Alison Joe Thorpe | Respite Care | 336 Gerland Rd, Rice Lake, WI 54868 | 2018-08-07 |
| 1669997946 | Char Mlejnek | Registered Nurse | 1700 W. Stout Street, Rice Lake, WI 54868 | 2017-08-08 |
| 1801344650 | Cumberland Memorial Hospital Inc | Occupational Therapist | 1895 20 1/2 Avenue, Rice Lake, WI 54868 | 2016-09-21 |
| 1851849814 | Leroy A Odden | Registered Nurse | 2135 20 1/8 Ave, Rice Lake, WI 54868 | 2016-09-19 |
| 1871903799 | Courtney Lange | Occupational Therapist | 910 Bear Paw Avenue, Rice Lake, WI 54868 | 2014-04-30 |
| 1063859130 | Mikeal Robert Ostrander | Optometrist | 320 County Highway O, Shopko Optical, Rice Lake, WI 54868 | 2013-05-30 |
| 1487976239 | Dale Henry Pracht | Pharmacist | 2601 South Main St, Kmart Pharmacy, Rice Lake, WI 54868 | 2010-02-22 |
| 1104159870 | Dianne Marie Thompson | Hearing Instrument Specialist | 212 S. Main St., Rice Lake, WI 54868 | 2009-09-14 |
| 1760646806 | Lori Ann Click Gray | Pediatrics | 736 Pine Place, Rice Lake, WI 54868 | 2008-07-17 |
| Find all providers in zip 54868 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (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. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801892435 | First American Enterprises, Inc | Skilled Nursing Facility | 19 West Newton St, Rice Lake, WI 54868-1744 | 2005-06-28 |
| 1922618768 | Rice Lake Care Center, LLC | Skilled Nursing Facility | 1016 Lakeshore Dr, Rice Lake, WI 54868-1225 | 2020-08-06 |
| 1063962454 | Rice Lake Operations LLC | Skilled Nursing Facility | 1016 Lakeshore Dr, Rice Lake, WI 54868-1225 | 2016-10-10 |
| 1457806176 | Heritage Rice Lake Operations LLC | Skilled Nursing Facility | 19 W Newton St, Rice Lake, WI 54868-1744 | 2016-08-23 |
| 1790176816 | Rice Lake Convalescent Center | Skilled Nursing Facility | 1016 Lakeshore Dr, Rice Lake, WI 54868-1225 | 2015-02-11 |
| 1518026566 | First American Enterprises Inc | Skilled Nursing Facility | 1016 Lakeshore Dr, Rice Lake, WI 54868-1225 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962369 | Heritage Assisted Living, LLC | Skilled Nursing Facility | 5020 S 107th St, Greenfield, WI 53228-3267 | 2020-04-30 |
| 1235762881 | Imr Oak Creek Opco, LLC | Skilled Nursing Facility | 2700 West Honadel Boulevard, Oak Creek, WI 53154 | 2020-02-21 |
| 1831693936 | Golden Years Nursing Home, Inc. | Skilled Nursing Facility | 611 Harmony Dr, Lake Geneva, WI 53147-8800 | 2018-03-22 |
| 1801302732 | Oak Park Place of Janesville, LLC | Skilled Nursing Facility | 700 Myrtle Way, Janesville, WI 53545-9101 | 2017-12-14 |
| 1235674839 | Zachary Rader | Skilled Nursing Facility | 645 N Church St, Elkhorn, WI 53121-2204 | 2017-01-05 |
| 1982155248 | The Bethany-st. Joseph Corporation D/b/a Prairie Pointe Rehab Suites | Skilled Nursing Facility | 286 N. Willson Dr, Altoona, WI 54720 | 2016-10-20 |
| 1316492317 | Darcy Christiansen | Skilled Nursing Facility | 4427 E Pic A Dilly Dr, Janesville, WI 53546-9606 | 2016-08-19 |
| 1366895583 | Jeffrey Alan Weinshrott | Skilled Nursing Facility | 336 Wisconsin Ave, Sheboygan, WI 53081-4183 | 2016-07-22 |
| 1720433378 | Kendra Meyers | Skilled Nursing Facility | 1806 N Hume Ave Apt 4, Marshfield, WI 54449-1677 | 2016-05-02 |
| 1952756991 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 206 North Willson Drive, Altoona, WI 54720 | 2016-04-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.