Classic Healthcare Services, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1662106 Issued in OH

Legal business name

CLASSIC HEALTHCARE SERVICES, LLC

Practice address

1105 Schrock Road Suite 206
Columbus, OH 43229-1704

Phone

(614) 848-3900

Fax

(614) 848-3901

NPI assigned

Jun 16, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Evaristus Basil Itie

Title

Ceo

Phone

(614) 848-3900

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Listed as

Classic Healthcare Services, LLCCCN 368314

Ownership

Proprietary

Certified

May 13, 2010

Services

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

Locations

Practitioners 1

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

• Everistus Basil Itie

  • Home Health Agency
  • Columbus, OH
  • NPI 1093883712
  NPD (past)

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472774400000",
    "number": "1073773719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SCHROCK ROAD SUITE 206",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432291704",
            "telephone_number": "614-848-3900",
            "fax_number": "614-848-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SCHROCK ROAD SUITE 206",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432291704",
            "telephone_number": "614-848-3900",
            "fax_number": "614-848-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2016-09-02",
        "status": "A",
        "authorized_official_last_name": "ITIE",
        "authorized_official_first_name": "EVARISTUS",
        "authorized_official_middle_name": "BASIL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-848-3900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "1662106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3069816",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latown T Clarkson, LPN
• Linda Clarkson
• Sylvia Clarkson, LISWS
• Richard Henry Clary, MD
• Classic Health Care Services, LLC
• Classic Mobile Dental Services-Cynthia Tufts White D.D.S., Inc
• Teresa Ann Claude
• Naryan Claudy
• Shaun M Clauss
• Marquita Clay Turner, CT

• Home Health Agency in Columbus, OH
• Providers in Columbus, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• 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.