Phoenix Home Health Care of Central Ohio LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PHOENIX HOME HEALTH CARE OF CENTRAL OHIO LLC

Practice address

30 Northwoods Blvd Ste 200
Columbus, OH 43235-4736

Phone

(614) 333-2200

NPI assigned

Oct 31, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Rajender A Reddy

Title

Ceo

Phone

(614) 333-2200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Home health agency certification: CCN 368108

Legal name

PHOENIX HOME HEALTH CARE OF CENTRAL OHIO LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 24, 2005

Last certification

Mar 21, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Oct 10, 2017 in OH

Enrollment address

30 Northwoods Blvd
Ste 200
Columbus, OH 43235-4736

Listed as

Phoenix Home Health Care of Central Ohio LLCCCN 368108

Ownership

Proprietary

Certified

Aug 24, 2005

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Phoenix Home Health Care Services, LTD

  • Home Health Agency
  • Columbus, OH
  • NPI 1013935931

  Acquired from, 2017-10-27

  CMS change of ownership

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509408000000",
    "number": "1184136152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NORTHWOODS BLVD STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432354736",
            "telephone_number": "614-333-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NORTHWOODS BLVD STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432354736",
            "telephone_number": "614-333-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOME HEALTH CARE OF CENTRAL OHIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-31",
        "last_updated": "2017-10-31",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "RAJENDER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-333-2200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Counseling Services
• Phoenix Health LLC
• Phoenix Health LLC
• Phoenix Health LLC
• Phoenix Home Care Passport Program Inc
• Phoenix Home Health Care Services, LTD
• Phoenix United Home Health
• Lessie Lucille Phommalee, LISW-S
• Christina Marie Phophan, LPN
• Veomany Phouthavong, CDCA

• 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 Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.