Clover LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

18-013565 Issued in IN

Legal business name

CLOVER LLC

Doing business as

Clover Home Health Care

Practice address

9765 Randall Dr Ste C
Carmel, IN 46280-1817

Phone

(844) 366-2587

Fax

(317) 536-3497

NPI assigned

Aug 1, 2018

Last updated

Oct 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carrie Tidwell, RN

Title

Owner

Phone

(844) 366-2587

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Clover Home Health Care Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275011355. Details of each certification follow.

• CCN 157724 Home health agency · Active · Details

Home health agency certification: CCN 157724

Legal name

CLOVER LLC

Doing business as

CLOVER HOME HEALTH CARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 2, 2022

Last certification

Nov 9, 2022

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

May 1, 2014 in IN

Enrollment address

9765 Randall Dr
Ste C
Carmel, IN 46280-1817
HHA Branch

Listed as

Clover Home Health CareCCN 157724 · All quality measures

Overall star rating

2 of 5

Ownership

Proprietary

Certified

Dec 2, 2022

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 3

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

Affiliated clinicians 3

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

• Allison K Harris, NP

  • Nurse Practitioner
  • McCordsville, IN
  • NPI 1033756853

  Home health agency

  Care Compare affiliation
• Julienne Elaine Leyva, ANP

  • Adult Health Nurse Practitioner
  • Pendleton, IN
  • NPI 1972762516

  Home health agency

  Care Compare affiliation
• Nicole L O'Rourke, NP

  • Family Nurse Practitioner
  • Indianapolis, IN
  • NPI 1336377670

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1275011355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9765 RANDALL DR STE C",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "462801817",
            "telephone_number": "844-366-2587",
            "fax_number": "317-536-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9765 RANDALL DR STE C",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "462801817",
            "telephone_number": "844-366-2587",
            "fax_number": "317-536-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-01",
        "last_updated": "2023-10-11",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "844-366-2587",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "18-013565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300006917",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300071957",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clover Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maret R Cline, M.D.
• Megan Cline
• Danielle Dean Clinkscales, OTR
• John Andrew Clinton
• Jennifer Cloud, MOT, OTR
• Maya O Cloyd, MD
• Brooke Coates, CCC-SLP
• Adam Coats, DC
• Alena Coats
• Michelle Coats, DC

• Home Health Agency in Carmel, IN
• Providers in Carmel, IN by specialty
• Home Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.