NPIMap

Organization Active NPI

H-Shalom Home Health Care LLC

  • Home Health Agency
  • Aurora, CO
National Provider Identifier
1326496738
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
04V344 Issued in CO
Legal business name
H-SHALOM HOME HEALTH CARE LLC
Practice address
2821 S Parker Rd Ste 1235
Aurora, CO 80014-2713
Phone
(303) 332-2971
NPI assigned
May 25, 2016
Last updated
May 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Authorized official

Name
Michael Kebede Hailemariam, MPA
Title
Managing Director and Cfo
Phone
(303) 332-2971

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 04V344 CO Primary

Addresses

Primary practice location

2821 S Parker Rd Ste 1235
Aurora, CO 80014-2713

Mailing address

2821 S Parker Rd Ste 1235
Aurora, CO 80014-2713
Phone (303) 332-2971

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160913001535 CO Part A Provider - Home Health Agency 8628364908 Practice locations: Aurora, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326496738. Details of each certification follow.

Home health agency certification: CCN 067586

Legal name
H-SHALOM HOME HEALTH CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 28, 2020
Last certification
May 28, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
2821 S Parker Rd
Ste 1235
Aurora, CO 80014-2713

Care Compare: Home health agency

Medicare Care Compare
Listed as
H-Shalom Home Health Care Agency LLCCCN 067586 · All quality measures
Ownership
Proprietary
Certified
May 28, 2020
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
H-Shalom Home Health Care LLC2 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

2821 S Parker Rd
Ste 1235
Aurora, CO 80014
Phone (303) 332-2971

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Girma K Hailemariam Individual 5% Or Greater Direct Ownership Interest Jan 1, 2016 20%
Operational/Managerial ControlOperation Manage Jan 1, 2016
Michael K Hailemariam Individual 5% Or Greater Direct Ownership Interest Jan 1, 2016 45%
Corporate OfficerCfo and Managing Director Jan 1, 2016
Hanna D Shembulo Individual 5% Or Greater Direct Ownership Interest Jan 1, 2016 25%
Operational/Managerial ControlAdministrator Jan 1, 2016
Selamawit B Haile Individual 5% Or Greater Direct Ownership Interest Jan 1, 2016 10%
Operational/Managerial ControlOffice Manager Jan 1, 2016

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1326496738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 S PARKER RD STE 1235",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142713",
            "telephone_number": "303-332-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 S PARKER RD STE 1235",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142713",
            "telephone_number": "303-332-2971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H-SHALOM HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-25",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A",
        "authorized_official_last_name": "HAILEMARIAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KEBEDE",
        "authorized_official_title_or_position": "MANAGING DIRECTOR AND CFO",
        "authorized_official_telephone_number": "303-332-2971",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CO",
            "license": "04V344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.