Madison 57 Investments LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MADISON 57 INVESTMENTS LLC

Practice address

6434 E Main St Ste 204
Reynoldsburg, OH 43068-7300

Phone

(614) 394-9105

NPI assigned

Oct 8, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Khem R Dhamala

Title

Assistant Adminstrator

Phone

(614) 394-9105

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Madison Home Health Services Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Home health agency certification: CCN 369125

Legal name

MADISON 57 INVESTMENTS LLC

Doing business as

MADISON HOME HEALTH SERVICES

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 16, 2015

Last certification

Sep 13, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Aug 22, 2013 in OH

Enrollment address

6434 E Main St
Ste 204
Reynoldsburg, OH 43068-7300

Listed as

Madison Home Health ServicesCCN 369125

Ownership

Proprietary

Certified

Oct 16, 2015

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

Locations

All disclosed owners & managing parties 4

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

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

{
    "created_epoch": "1381190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1225465172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6434 E MAIN ST STE 204",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430687300",
            "telephone_number": "614-394-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6434 E MAIN ST STE 204",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430687300",
            "telephone_number": "614-394-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON 57 INVESTMENTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-08",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "DHAMALA",
        "authorized_official_first_name": "KHEM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ASSISTANT ADMINSTRATOR",
        "authorized_official_telephone_number": "614-394-9105",
        "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": "0165026",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison Home Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Madison Home Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Reynoldsburg, OH
• Providers in Reynoldsburg, 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 19, 2023; 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.