NPIMap

Organization Active NPI

Serenity Homecare LLC

  • In Home Supportive Care Agency
  • Indianapolis, IN
National Provider Identifier
1184496986
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
SERENITY HOMECARE LLC
Practice address
4837 Oakbrook Dr
Indianapolis, IN 46254-1117
Phone
(317) 903-3007
Fax
(463) 900-1728
NPI assigned
Oct 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Authorized official

Name
Dominique McGordonNPI 1336920867
Title
Owner
Phone
(317) 903-3007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary
Personal Care AttendantGroup: 193200000X MULTI-SPECIALTY GROUP 3747P1801X
HomemakerGroup: 193200000X MULTI-SPECIALTY GROUP 376J00000X

Addresses

Primary practice location

4837 Oakbrook Dr
Indianapolis, IN 46254-1117

Mailing address

4837 Oakbrook Dr
Indianapolis, IN 46254-1117
Phone (317) 903-3007

National Provider Directory

National Provider Directory

Locations

4837 Oakbrook Dr
Indianapolis, IN 46254
Phone (317) 903-3007

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1184496986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4837 OAKBROOK DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462541117",
            "telephone_number": "317-903-3007",
            "fax_number": "463-900-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4837 OAKBROOK DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462541117",
            "telephone_number": "317-903-3007",
            "fax_number": "463-900-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "MCGORDON",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-903-3007"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.