Great Home Healthcare, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GREAT HOME HEALTHCARE, LLC

Practice address

2999 E Dublin Granville Rd Ste 215
Columbus, OH 43231-4030

Phone

(614) 475-4026

NPI assigned

Mar 11, 2010

Last updated

Mar 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Khadra Jama

Title

Administrator

Phone

(614) 475-4026

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Great Home Healthcare LLC. Former legal business name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043533524. Details of each certification follow.

• CCN 368483 Home health agency · Active · Details

Home health agency certification: CCN 368483

Legal name

GREAT HOME HEALTHCARE, LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 13, 2012

Last certification

Mar 12, 2020

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Jan 10, 2010 in OH

Enrollment address

2999 E. Dublin Granville Rd.
Suite 215
Columbus, OH 43231

Listed as

Great Home Healthcare, LLCCCN 368483 · All quality measures

Ownership

Proprietary

Certified

Dec 13, 2012

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

CLIA laboratory certificates

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.

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1043533524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2999 E DUBLIN GRANVILLE RD STE 215",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432314030",
            "telephone_number": "614-475-4026",
            "fax_number": "614-475-4238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2999 E DUBLIN GRANVILLE RD STE 215",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432314030",
            "telephone_number": "614-475-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT HOME HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-11",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "JAMA",
        "authorized_official_first_name": "KHADRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "614-475-4026"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0092606",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "greathh3@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Secure email address for receiving medical documents",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "may send other forms of documentation",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "na",
            "address_1": "2999 E Dublin Granville Rd Ste 215",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432314030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Great Home Healthcare LLC.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Great Home Healthcare LLC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.