Atlantic Home Health Care, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1184 Issued in WI

Legal business name

ATLANTIC HOME HEALTH CARE, INC

Practice address

5600 West Brown Deer Road
#216
Brown Deer, WI 53223

Phone

(414) 797-0739

Fax

(414) 797-0743

NPI assigned

Dec 2, 2013

Last updated

Oct 12, 2015By 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

Mrs. Anjelika Khalatyants

Title

Executive Director

Phone

(414) 797-0739

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346671302. Details of each certification follow.

• CCN 527324 Home health agency · Active · Details

Home health agency certification: CCN 527324

Legal name

ATLANTIC HOME HEALTH CARE, INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 26, 2016

Last certification

Jul 10, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Dec 2, 2013 in WI

Enrollment address

5600W Brown Deer Rd 216
Brown Deer, WI 53223-2346
HHA Branch

Listed as

Atlantic Home Health CareCCN 527324 · All quality measures

Ownership

Proprietary

Certified

Jul 26, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Occupational therapy

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.

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444608000000",
    "number": "1346671302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 WEST BROWN DEER ROAD",
            "address_2": "#216",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "53223",
            "telephone_number": "414-797-0739",
            "fax_number": "414-797-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 WEST BROWN DEER ROAD",
            "address_2": "#216",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "53223",
            "telephone_number": "414-797-0739",
            "fax_number": "414-797-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC HOME HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-02",
        "last_updated": "2015-10-12",
        "status": "A",
        "authorized_official_last_name": "KHALATYANTS",
        "authorized_official_first_name": "ANJELIKA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "414-797-0739",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WI",
            "license": "1184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Brown Deer, WI
• Providers in Brown Deer, WI by specialty
• Home Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.