Organization Active NPI

Adorn Senior Home Care LLC

  • Home Health Agency
  • Omaha, NE
National Provider Identifier
1235770488
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ADORN SENIOR HOME CARE LLC
Practice address
14916 Redman Ave
Omaha, NE 68116-1448
Phone
(402) 637-2373
NPI assigned
Sep 30, 2019
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Jerry MarcosNPI 1679467807
Title
Owner
Phone
(402) 637-2373

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

Practitioners 1

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Adorn Senior Home Care, LLCCCN 287804
Ownership
-
Certified
Nov 29, 2023
Medicare certification status
ActiveFrom the Provider of Services file

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
28D2270844Adorn Senior Home Care LLC4611 S 96TH Street, Suite 223, Omaha, NE 68127Certificate of waiverOct 20, 2026

Medicare participation

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

Home health agency certification: CCN 287804

Medicare enrollment files
Legal name
ADORN SENIOR HOME CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 29, 2023
Last certification
Nov 22, 2023
Organization structure
LLCProprietary
Incorporated
Sep 27, 2019 in NE
Enrollment address
4611 S 96TH St
Ste 223
Omaha, NE 68127-1243

All disclosed owners & managing parties 1

Medicare enrollment files

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

NameRoleSinceShare
Jerry Marcos Individual 5% Or Greater Direct Ownership Interest Jun 24, 2022 100%
Corporate OfficerPresident/Ceo Jun 24, 2022
Corporate DirectorPresident/Ceo Jun 24, 2022
W-2 Managing EmployeePresident/Ceo Jun 24, 2022
Operational/Managerial ControlPresident/Ceo Jun 24, 2022

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20220914000676 NE Part a Provider - Home Health Agency 8022493972 Practice locations: Omaha, NE

National Provider Directory

National Provider Directory

Locations

4611 S 96th St
Ste 223
Omaha, NE 68127
Phone (308) 672-6043

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

14916 Redman Ave
Omaha, NE 68116-1448

Mailing address

14916 Redman Ave
Omaha, NE 68116-1448
Phone (402) 637-2373

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 30, 2019.

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569801600000",
    "number": "1235770488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14916 REDMAN AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681161448",
            "telephone_number": "402-637-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14916 REDMAN AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681161448",
            "telephone_number": "402-637-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADORN SENIOR HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A",
        "authorized_official_last_name": "MARCOS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-637-2373"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.