Organization Active NPI

Mesa Home Healthcare LLC

  • Home Health Agency
  • Columbus, OH
National Provider Identifier
1043074297
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MESA HOME HEALTHCARE LLC
Practice address
733 E Dublin Granville Rd Ste 20
Columbus, OH 43229-3200
Phone
(619) 707-3555
NPI assigned
Feb 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Authorized official

Name
Fadumo A Jama
Title
Admin
Phone
(619) 707-3555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

733 E Dublin Granville Rd Ste 20
Columbus, OH 43229-3200

Mailing address

733 E Dublin Granville Rd Ste 20
Columbus, OH 43229-3200
Phone (619) 707-3555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240821000169 OH Part A Provider - Home Health Agency 8123566221 Practice locations: Columbus, OH

Home health agency certification: CCN 369427

Legal name
MESA HOME HEALTHCARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 5, 2025
Last certification
Nov 12, 2025
Organization structure
LLCProprietary
Incorporated
Feb 6, 2024 in OH
Enrollment address
733 E Dublin Granville Rd
Ste 20
Columbus, OH 43229-3200
HHA Branch

National Provider Directory

National Provider Directory

Locations

733 E Dublin Granville Rd
Ste 20
Columbus, OH 43229
Phone (619) 707-3555

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Fadumo Jama Individual Contracted Managing Employee Feb 6, 2024 30%
5% Or Greater Direct Ownership Interest Feb 6, 2024 30%
5% Or Greater Indirect Ownership Interest Feb 6, 2024 30%
5% Or Greater Mortgage Interest Feb 6, 2024 30%
5% Or Greater Security Interest Feb 6, 2024 30%
General Partnership Interest Feb 6, 2024 30%
Limited Partnership Interest Feb 6, 2024 30%
Corporate Officer Feb 6, 2024 30%
Corporate Director Feb 6, 2024 30%
W-2 Managing Employee Feb 6, 2024 30%
Operational/Managerial Control Feb 6, 2024
Omar Aden Individual Contracted Managing Employee Feb 6, 2024 30%
5% Or Greater Direct Ownership Interest Feb 6, 2024 30%
5% Or Greater Indirect Ownership Interest Feb 6, 2024 30%
5% Or Greater Mortgage Interest Feb 6, 2024 30%
5% Or Greater Security Interest Feb 6, 2024 30%
General Partnership Interest Feb 6, 2024 30%
Limited Partnership Interest Feb 6, 2024 30%
Corporate Officer Feb 6, 2024 30%
Corporate Director Feb 6, 2024 30%
W-2 Managing Employee Feb 6, 2024 30%
Sheriff Nurre Individual Contracted Managing Employee Feb 6, 2024 40%
5% Or Greater Direct Ownership Interest Feb 6, 2024 40%
5% Or Greater Indirect Ownership Interest Feb 6, 2024 40%
5% Or Greater Mortgage Interest Feb 6, 2024 40%
5% Or Greater Security Interest Feb 6, 2024 40%
General Partnership Interest Feb 6, 2024 40%
Limited Partnership Interest Feb 6, 2024 40%
Corporate Officer Feb 6, 2024 40%
Corporate Director Feb 6, 2024 40%
W-2 Managing Employee Feb 6, 2024 40%

NPI Registry JSON

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1043074297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 E DUBLIN GRANVILLE RD STE 20",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293200",
            "telephone_number": "619-707-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 E DUBLIN GRANVILLE RD STE 20",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293200",
            "telephone_number": "619-707-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA HOME HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "JAMA",
        "authorized_official_first_name": "FADUMO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "619-707-3555"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.