NPIMap

Organization Active NPI

Serenity Homecare LLC

  • In Home Supportive Care Agency
  • Omaha, NE
National Provider Identifier
1003576109
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
SERENITY HOMECARE LLC
Practice address
4611 S 96TH St Ste 226
Omaha, NE 68127-1243
Phone
(402) 267-6304
NPI assigned
Dec 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Authorized official

Name
Ms. Heather Sims
Title
Owner
Phone
(316) 944-9723

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

4611 S 96TH St Ste 226
Omaha, NE 68127-1243

Mailing address

4611 S 96TH St Ste 226
Omaha, NE 68127-1243
Phone (402) 267-6304

Other identifiers 1

IdentifierTypeStateIssuer
28857339MedicaidNE

National Provider Directory

National Provider Directory

Locations

4611 S 96th St
Ste 226
Omaha, NE 68127
Phone (402) 267-6304

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1003576109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 S 96TH ST STE 226",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271243",
            "telephone_number": "402-267-6304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 S 96TH ST STE 226",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271243",
            "telephone_number": "402-267-6304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-30",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-944-9723",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28857339",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.