Active NPI
Adorn Senior Home Care LLC
- Home Health Agency
- Omaha, NE
On this page
- Key facts
- Authorized official
- Practitioners1
- Care Compare: Home health agency
- Laboratory certificates & supplier records
- Medicare participation
- Home health agency certification: CCN 287804
- All disclosed owners & managing parties1
- Medicare enrollment records1
- National Provider Directory
- Specialties & licenses1
- Addresses
- NPI Registry JSON
- Other providers in Omaha, NE
- Sources for this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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 Marcos
- 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.
-
- Nurse's Aide
- Omaha, NE
- NPI 1679467807
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Adorn Senior Home Care, LLC
- Ownership
- -
- Certified
- Nov 29, 2023
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 28D2270844 | Adorn Senior Home Care LLC | Certificate of waiver | Oct 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
- LLC
- 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 filesAs disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Jerry Marcos | 5% Or Greater Direct Ownership Interest | Jun 24, 2022 | 100% |
| Corporate Officer | Jun 24, 2022 | ||
| Corporate Director | Jun 24, 2022 | ||
| W-2 Managing Employee | Jun 24, 2022 | ||
| Operational/Managerial Control | Jun 24, 2022 |
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220914000676 | NE | Part a Provider - Home Health Agency | 8022493972 | Practice locations: Omaha, NE |
National Provider Directory
National Provider DirectoryLocations
4611 S 96th St
Ste 223
Omaha, NE 68127
Phone (308) 672-6043
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
NPPES NPI RegistryPrimary 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.