Pennell Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

2103421 Issued in OH

Legal business name

PENNELL HEALTHCARE LLC

Practice address

2525 Oakstone Dr
Suite a
Columbus, OH 43231-8625

Phone

(614) 899-2500

Fax

(614) 899-2509

NPI assigned

Jun 26, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Judith Lemme MbougeNPI 1588803423

Title

Marketing Officer

Phone

(614) 899-2500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Home health agency certification: CCN 369112

Legal name

PENNELL HEALTHCARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 8, 2015

Last certification

Sep 21, 2017

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Apr 27, 2012 in OH

Enrollment address

2525 Oakstone Dr Ste a
Columbus, OH 43231-8626

Listed as

Pennell Healthcare LLCCCN 369112

Ownership

Proprietary

Certified

Apr 8, 2015

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Locations

All disclosed owners & managing parties 1

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Judith Leme Mbouge, STNA

  • Nurse's Aide
  • Columbus, OH
  • NPI 1588803423
  NPD Authorized official

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439251200000",
    "number": "1336403278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 OAKSTONE DR",
            "address_2": "SUITE A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432318625",
            "telephone_number": "614-899-2500",
            "fax_number": "614-899-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 OAKSTONE DR",
            "address_2": "SUITE A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432318625",
            "telephone_number": "614-899-2500",
            "fax_number": "614-899-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNELL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-26",
        "last_updated": "2015-08-11",
        "status": "A",
        "authorized_official_last_name": "MBOUGE",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "LEMME",
        "authorized_official_title_or_position": "MARKETING OFFICER",
        "authorized_official_telephone_number": "614-899-2500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "2103421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Penn
• Italia Cheyenne Penn
• Kathryn Penn
• Kelci Ann Penn
• Seaonya Penn
• Kara Ann Penniman, LISW-S
• Pennington Gap
• Anita Pennington, LSW
• Ashley N Pennington, NP-C
• Christina M. Pennington, C.R.N.A.

• Home Health Agency in Columbus, OH
• Providers in Columbus, 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 Aug 11, 2015; 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.