NPIMap

Organization Active NPI

Interim Healthcare of SE Indiana, Inc.

  • Home Health Agency
  • Columbus, IN
National Provider Identifier
1083682728
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
05-003257-1 Issued in IN
Legal business name
INTERIM HEALTHCARE OF SE INDIANA, INC.
Practice address
3200 N National Rd
Columbus, IN 47201-3166
Phone
(812) 799-1846
Fax
(812) 799-1848
NPI assigned
Mar 9, 2006
Last updated
Aug 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Authorized official

Name
Mr. Thomas J Dimarco
Title
Ceo
Phone
(614) 436-9404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 05-003257-1 IN Primary

Addresses

Primary practice location

3200 N National Rd
Columbus, IN 47201-3166

Mailing address

3200 N National Rd
Columbus, IN 47201-3166
Phone (812) 799-1846

Other identifiers 3

IdentifierTypeStateIssuer
000000346938OtherINANTHEM
200468700MedicaidIN
200424030MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030415000008 IN Part A Provider - Home Health Agency 8527977446 Practice locations: Columbus, IN; Lawrenceburg, IN; Richmond, IN; Scottsburg, IN; Bloomington, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083682728. Details of each certification follow.

Home health agency certification: CCN 157551

Legal name
INTERIM HEALTHCARE OF SE INDIANA, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 14, 2003
Last certification
Sep 16, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jan 28, 2002 in IN
Enrollment address
401 W Eads Pkwy
Ste 350
Lawrenceburg, IN 47025-1380
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Interim Healthcare of SE Indiana IncCCN 157551 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Aug 14, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, 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
15D1023396Interim Healthcare of SE Indiana, Inc3200 North National Road, Columbus, IN 47201Certificate of waiverMar 15, 2028

National Provider Directory

National Provider Directory
Tax ID family
Interim Healthcare of Evansville2 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.

Locations

2620 N Walnut St
Ste 300
Bloomington, IN 47404
Phone (812) 727-3200

3100 N National Rd
Columbus, IN 47025

3200 N National Rd
Columbus, IN 47201
Phone (812) 799-1846

227 Tebbs Ave
Greendale, IN 47025
Phone (812) 537-5546

401 W Eads Pkwy
Ste 350
Lawrenceburg, IN 47025
Phone (812) 537-5546

500 W Eads Pkwy
Lawrenceburg, IN 47025
Phone (812) 577-3697

2519 E Main St
Ste 210212
Richmond, IN 47374
Phone (765) 383-3951

571 S Lake Rd S
Scottsburg, IN 47170
Phone (812) 414-2888

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Angela Johnson Individual Corporate OfficerVice President Feb 1, 2022
W-2 Managing EmployeeVice President Feb 1, 2022
Nicholas Reiser Individual Corporate OfficerVice President & Coo Feb 1, 2022
Corporate DirectorDirector Feb 1, 2022
Salo Inc Organization, Worthington, OH Corporation, Management services company, For-profit 5% Or Greater Direct Ownership Interest Oct 31, 2007 100%
Christine D Oswald Individual 5% Or Greater Indirect Ownership Interest Apr 16, 2004 8.56%
Corporate Officer Apr 16, 2004 8.56%
Corporate Director Apr 16, 2004 8.56%
Thomas Joseph Dimarco Individual 5% Or Greater Indirect Ownership Interest Nov 7, 2004 75.78%
Corporate Officer Nov 7, 2004 75.78%
Corporate Director Oct 31, 2007 75.78%
Diane S Piccard Individual Corporate OfficerCco Jul 19, 2016

Facilities with the same owner 24

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

View all 24

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1083682728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 N NATIONAL RD",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472013166",
            "telephone_number": "812-799-1846",
            "fax_number": "812-799-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 N NATIONAL RD",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472013166",
            "telephone_number": "812-799-1846",
            "fax_number": "812-799-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIM HEALTHCARE OF SE INDIANA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "DIMARCO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-436-9404",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "05-003257-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000346938",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200468700",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200424030",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.