Champion City Home Health Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CHAMPION CITY HOME HEALTH CARE LLC

Practice address

1030 N Fountain Ave
Springfield, OH 45504-2228

Phone

(937) 504-2915

NPI assigned

Feb 11, 2022

Organization subpart

No

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

Authorized official

Name

Jerome Vinson

Title

Owner

Phone

(937) 408-1231

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Home health agency certification: CCN 369355

Legal name

CHAMPION CITY HOME HEALTH CARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 12, 2023

Last certification

May 4, 2023

Organization structure

LLCProprietary

Incorporated

Sep 9, 2021 in OH

Enrollment address

1030 N Fountain Ave
Springfield, OH 45504-2228

Listed as

Champion City Home Health Care LLCCCN 369355 · All quality measures

Ownership

-

Certified

May 12, 2023

Medicare certification status

ActiveFrom the Provider of Services file

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 2

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": "1644537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1235883893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 N FOUNTAIN AVE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 N FOUNTAIN AVE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042228",
            "telephone_number": "937-504-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION CITY HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "VINSON",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-408-1231"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amrit Lal Chadha, MD
• Ceasyn Chaffee
• Challa Ajit, M.D. LLC
• Jyothi Challa, MD
• Aziza Hadiya Chambers, AT, ATC
• Rachael Chaplin
• Angeline Janise Chapman
• Deborah Brennan Chapman, SLP
• Helen Louise Chapman
• Jessica Raylene Chapman, CDCA

• Home Health Agency in Springfield, OH
• Providers in Springfield, 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 Feb 11, 2022; 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.