Organization Active NPI

Senior Homecare Unlimited, LLC

  • Home Health Agency
  • Mount Orab, OH
National Provider Identifier
1073828422
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SENIOR HOMECARE UNLIMITED, LLC
Practice address
100 Liming Farm Rd
Mount Orab, OH 45154-8944
Phone
(937) 444-6100
Fax
(937) 444-7009
NPI assigned
Aug 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Authorized official

Name
Mr. Joshua R Fry
Title
Owner
Phone
(937) 444-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

100 Liming Farm Rd
Mount Orab, OH 45154-8944

Mailing address

100 Liming Farm Rd
Mount Orab, OH 45154-8944
Phone (937) 444-6100

Other practice location 1

111 N High St
Mount Orab, OH 45154-8971
Phone (937) 444-0930

Other practice location 2

459 W Main St
Mount Orab, OH 45154-9598
Phone (937) 444-0930

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120627000015 OH Part A Provider - Home Health Agency 0648435529 Practice locations: Mount Orab, OH

Home health agency certification: CCN 368467

Legal name
SENIOR HOMECARE UNLIMITED, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 14, 2013
Last certification
Aug 24, 2017
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
100 Liming Farm Rd
Mount Orab, OH 45154-8944

Care Compare: Home health agency

Medicare Care Compare
Listed as
Senior Homecare Unlimited LLCCCN 368467
Ownership
Proprietary
Certified
Jan 14, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, 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
36D2047600Senior Homecare Unlimited LLC459 W Main St Ste a, Mount Orab, OH 45154Certificate of waiverSep 26, 2026

National Provider Directory

National Provider Directory

Locations

459 W Main St
Mount Orab, OH 45154
Phone (937) 444-0930

459 W Main St
Ste A
Mount Orab, OH 45154

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
Joshua Fry Individual 5% Or Greater Direct Ownership Interest Feb 13, 2012
W-2 Managing Employee Feb 13, 2012

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1073828422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LIMING FARM RD",
            "city": "MOUNT ORAB",
            "state": "OH",
            "postal_code": "451548944",
            "telephone_number": "937-444-6100",
            "fax_number": "937-444-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LIMING FARM RD",
            "city": "MOUNT ORAB",
            "state": "OH",
            "postal_code": "451548944",
            "telephone_number": "937-444-6100",
            "fax_number": "937-444-7009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 N High St",
            "address_purpose": "LOCATION",
            "city": "Mount Orab",
            "state": "OH",
            "postal_code": "451548971",
            "country_code": "US",
            "telephone_number": "937-444-0930",
            "fax_number": "937-444-4564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "459 W Main St",
            "address_purpose": "LOCATION",
            "city": "Mount Orab",
            "state": "OH",
            "postal_code": "451549598",
            "country_code": "US",
            "telephone_number": "937-444-0930",
            "fax_number": "937-444-7009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SENIOR HOMECARE UNLIMITED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-10",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "FRY",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-444-6100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Orab, OH

Sources for this page

Verify at the official NPI Registry.