Bluemoon Home Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

BLUEMOON HOME HEALTHCARE LLC

Practice address

5705 Tamarack Blvd Apt F
Columbus, OH 43229-3776

Phone

(614) 721-0714

NPI assigned

Dec 8, 2021

Last updated

Dec 8, 2021By 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

Mohamed Isse Mohamud

Title

Owner

Phone

(619) 321-7065

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1104585058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 TAMARACK BLVD APT F",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293776",
            "telephone_number": "614-721-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5705 TAMARACK BLVD APT F",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293776",
            "telephone_number": "614-721-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEMOON HOME HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "MOHAMUD",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "ISSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-321-7065"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "same",
            "affiliation": "N",
            "endpointDescription": "same place",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "n/a",
            "address_1": "5705 Tamarack Blvd Apt F",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432293776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• 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 Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.