NPIMap

Organization Active NPI

Mercy Medical Center Home Health & Hospice LLC

  • Home Health Agency
  • Canton, OH
National Provider Identifier
1073972550
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MERCY MEDICAL CENTER HOME HEALTH & HOSPICE LLC
Practice address
4369 Whipple Ave NW
Canton, OH 44718-2643
Phone
(234) 203-3223
NPI assigned
Feb 12, 2016
Last updated
Mar 7, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Authorized official

Name
Mr. David K Stewart
Title
Sr VP Finance / Cfo
Phone
(330) 489-1131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4369 Whipple Ave NW
Canton, OH 44718-2643

Mailing address

4369 Whipple Ave NW
Canton, OH 44718-2643
Phone (234) 203-3223

Other identifiers 1

IdentifierTypeStateIssuer
0298771MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160825000902 OH Part A Provider - Home Health Agency 8628368990 Practice locations: Canton, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073972550. Details of each certification follow.

Home health agency certification: CCN 367256

Legal name
MERCY MEDICAL CENTER HOME HEALTH & HOSPICE, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 19, 1984
Last certification
Jan 9, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Nov 30, 2015 in OH
Enrollment address
4369 Whipple Ave NW
Canton, OH 44718-2643

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Mercy Medical Center Home Health & Hospice LLCCCN 367256 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Oct 19, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Mercy Medical Center HH Hospice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Cleveland Clinic Mercy Hospital Organization, Canton, OH Corporation, Medical provider/supplier, Non-profit 5% Or Greater Direct Ownership Interest Dec 31, 2015 100%
Everett Neal Individual Corporate OfficerPresident Dec 26, 2018
Tessie Ganzsarto Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2016 5%
Alternate Solutions Health Network LLC Organization, Kettering, OH 5% Or Greater Indirect Ownership Interest Jan 1, 2016 40%
Darlene E King-Mayberry Individual W-2 Managing EmployeeAd; Nov 1, 2024
Alternate Solutions Homecare North East LLC Organization, Kettering, OH 5% Or Greater Direct Ownership Interest Jan 1, 2016 40%
David Stewart Individual Corporate OfficerSr Vice President & Cfo Nov 16, 2015
Warren David Ganzsarto Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2016 35%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 20

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 20

Practitioners & affiliated clinicians

Affiliated clinicians 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488844800000",
    "number": "1073972550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4369 WHIPPLE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182643",
            "telephone_number": "234-203-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4369 WHIPPLE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182643",
            "telephone_number": "234-203-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL CENTER HOME HEALTH & HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2017-03-07",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SR VP FINANCE / CFO",
        "authorized_official_telephone_number": "330-489-1131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0298771",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.