NPIMap

Organization Active NPI

Mercy Health Services LLC

  • Home Health Agency
  • Mandeville, LA
National Provider Identifier
1265544746
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MERCY HEALTH SERVICES LLC
Practice address
5150 Highway 22 Ste C9
Mandeville, LA 70471-2668
Phone
(985) 674-1699
NPI assigned
Aug 31, 2006
Last updated
Jan 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Authorized official

Name
Kevin Mark Kramer
Title
Owner
Phone
(985) 674-1699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

5150 Highway 22 Ste C9
Mandeville, LA 70471-2668

Mailing address

5150 Highway 22
Mandeville, LA 70471-2620
Phone (985) 674-1699

Other practice location 1

71677 Riverside Dr
Covington, LA 70433-9031
Phone (985) 674-1699

Other identifiers 1

IdentifierTypeStateIssuer
1406686MedicaidLA

Other names 1

  • Mercy Health Services LLC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200526001009 LA Part A Provider - Home Health Agency 8527489723 Practice locations: Mandeville, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265544746. Details of each certification follow.

Home health agency certification: CCN 197767

Legal name
MERCY HEALTH SERVICES LLC
Doing business as
MERCY HOME HEALTH SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 5, 2001
Last certification
Sep 23, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Feb 21, 2020 in LA
Enrollment address
1011 N Causeway Blvd
Ste 19
Mandeville, LA 70471-3419

Care Compare: Home health agency

Medicare Care Compare
Listed as
Mercy Home Health ServicesCCN 197767 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Jan 5, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
19D0976807Mercy Health Services, LLC1011 N Causeway Blvd Suite 19, Mandeville, LA 70471Certificate of waiverAug 14, 2026

National Provider Directory

National Provider Directory
Tax ID family
Interim Healthcare of Southeast la Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

71677 Riverside Dr
Covington, LA 70433
Phone (985) 674-1699

1011 N Causeway Blvd
Ste 19
Mandeville, LA 70471
Phone (985) 674-1699

235 Saint Ann Dr
Ste 3
Mandeville, LA 70471
Phone (985) 674-1699

5150 Highway 22
Mandeville, LA 70471
Phone (985) 845-2454

825 Asbury Dr
Mandeville, LA 70471
Phone (985) 674-1699

4317 El Dorado St
Metairie, LA 70006
Phone (504) 291-6207

Ownership & related parties

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.

NameRoleSinceShare
Kevin Kramer Individual 5% Or Greater Direct Ownership Interest May 4, 2020 50%
Corporate OfficerCfo May 4, 2020 50%
Corporate DirectorBoard Member May 4, 2020 50%
Operational/Managerial ControlCfo May 4, 2020 50%
Gregory Killebrew Individual 5% Or Greater Direct Ownership Interest May 4, 2020 50%
Corporate OfficerBoard Member May 4, 2020 50%
Corporate DirectorBoard Member May 4, 2020 50%
Operational/Managerial ControlBoard Member May 4, 2020 50%

Change-of-ownership history 2

DateEventCounterparty
May 4, 2020 Change of OwnershipThis provider was the buyer Interim Healthcare of Southeast, la Inc.CCN 197767, LA, NPI 1265544746
May 4, 2020 Change of OwnershipThis provider was the seller Mercy Home Health ServicesCCN 197767, LA, NPI 1265544746

Practitioners & affiliated clinicians

Affiliated clinicians 23

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1265544746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 HIGHWAY 22",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704712620",
            "telephone_number": "985-674-1699",
            "fax_number": "985-626-7473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 HIGHWAY 22 STE C9",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704712668",
            "telephone_number": "985-674-1699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71677 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704339031",
            "country_code": "US",
            "telephone_number": "985-674-1699",
            "fax_number": "985-626-7473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MERCY HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "KRAMER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-674-1699"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1406686",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Health Services LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mandeville, LA

Sources for this page

Verify at the official NPI Registry.