NPIMap

Organization Active NPI

Casper Home Health, LLC

  • Home Health Agency
  • Casper, WY
National Provider Identifier
1336652452
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CASPER HOME HEALTH, LLC
Practice address
126 N Wilson St
Casper, WY 82601-2741
Phone
(307) 439-4110
NPI assigned
Nov 10, 2017
Last updated
Feb 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Authorized official

Name
Marc Berg
Title
Ceo
Phone
(360) 518-3226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

126 N Wilson St
Casper, WY 82601-2741

Mailing address

PO Box 381
Casper, WY 82602-0381
Phone (307) 439-4110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180618001099 WY Part A Provider - Home Health Agency 2264787142 Practice locations: Casper, WY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336652452. Details of each certification follow.

Home health agency certification: CCN 537084

Legal name
CASPER HOME HEALTH, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 4, 2018
Last certification
Nov 1, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jun 2, 2017 in WY
Enrollment address
126 N Wilson St
Casper, WY 82601-2741

Care Compare: Home health agency

Medicare Care Compare
Listed as
Casper Home Health LLCCCN 537084 · All quality measures
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Dec 4, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, 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
53D2150727Casper Home Health Care LLC126 North Wilson, Casper, WY 82601Certificate of waiverJul 1, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Nicholas GJ Healey Individual 5% Or Greater Direct Ownership Interest Dec 31, 2018 23.4%
Marc a Berg Individual 5% Or Greater Direct Ownership InterestPartner Jun 2, 2017 23.4%
Katherine Klein Individual 5% Or Greater Direct Ownership Interest Aug 1, 2018 13.3%
W-2 Managing EmployeeNurse Manager, Administrator Aug 1, 2018 13.3%
Susan Murtha Individual 5% Or Greater Direct Ownership InterestPartner Jun 2, 2017 6.6%
Valan Pearse Individual 5% Or Greater Direct Ownership InterestPartner, Office Manager Jun 2, 2017 20%
W-2 Managing EmployeeOffice Manager Jun 2, 2017
Marie Ryan Individual 5% Or Greater Direct Ownership InterestPartner Jun 2, 2017 13.3%

Practitioners & affiliated clinicians

Affiliated clinicians 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613088000000",
    "number": "1336652452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826020381",
            "telephone_number": "307-439-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 N WILSON ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012741",
            "telephone_number": "307-439-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASPER HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-10",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-518-3226"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.