Organization Active NPI

Nationwide Healthcare, LLC.

  • Home Health Agency
  • Parma, OH
National Provider Identifier
1003908559
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1479058 Issued in OH
Legal business name
NATIONWIDE HEALTHCARE, LLC.
Practice address
5700 Chevrolet Blvd
Parma, OH 44130-1412
Phone
(440) 888-8888
Fax
(440) 888-8895
NPI assigned
Sep 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Authorized official

Name
Mr. Chanthou Phay
Title
President
Phone
(440) 888-8888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1479058 OH Primary

Addresses

Primary practice location

5700 Chevrolet Blvd
Parma, OH 44130-1412

Mailing address

5700 Chevrolet Blvd
Parma, OH 44130-1412
Phone (440) 888-8888

Other identifiers 1

IdentifierTypeStateIssuer
2551340MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041104000255 OH Part A Provider - Home Health Agency 5395708093 Practice locations: Parma, OH

Home health agency certification: CCN 368095

Legal name
NATIONWIDE HEALTHCARE, LLC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 7, 2005
Last certification
Dec 12, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jul 26, 2004 in OH
Enrollment address
5700 Chevrolet Blvd
Parma, OH 44130-1412

Care Compare: Home health agency

Medicare Care Compare
Listed as
Nationwide Healthcare, LLCCCN 368095
Ownership
Proprietary
Certified
Apr 7, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1032147Nationwide Healthcare LLC5700 Chevrolet Blvd, Parma, OH 44130Certificate of waiverFeb 15, 2027

National Provider Directory

National Provider Directory

Locations

5500 Ridge Rd
Ste 211
Parma, OH 44129
Phone (440) 888-8888

6325 York Rd
Ste 101
Parma Heights, OH 44130
Phone (440) 842-5557

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Chanthou Phay Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2010 100%
Corporate OfficerCeo Jan 1, 2010 100%
Corporate DirectorCeo Jan 1, 2010 100%
W-2 Managing EmployeeCeo Jan 1, 2010 100%
Operational/Managerial ControlCeo Jan 1, 2010 100%

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1003908559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 CHEVROLET BLVD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441301412",
            "telephone_number": "440-888-8888",
            "fax_number": "440-888-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 CHEVROLET BLVD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441301412",
            "telephone_number": "440-888-8888",
            "fax_number": "440-888-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONWIDE HEALTHCARE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "PHAY",
        "authorized_official_first_name": "CHANTHOU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-888-8888",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "1479058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2551340",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

Verify at the official NPI Registry.