NPIMap

Organization Active NPI

In Home Health LLC

Doing business as ProMedica Hospice (Raleigh)

  • Community Based Hospice Care Agency
  • Raleigh, NC
National Provider Identifier
1386698199
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HOS2281 Issued in NC
Legal business name
IN HOME HEALTH LLC
Doing business as
ProMedica Hospice (Raleigh)
Practice address
4505 Falls of Neuse Rd
Suite 650
Raleigh, NC 27609-2523
Phone
(919) 877-9959
Fax
(919) 235-0770
NPI assigned
May 19, 2006
Last updated
Apr 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Authorized official

Name
Martin David Allen
Title
Director
Phone
(419) 252-5734

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HOS2281 NC Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X NU

Addresses

Primary practice location

4505 Falls of Neuse Rd
Suite 650
Raleigh, NC 27609-2523

Mailing address

333 N Summit St
Toledo, OH 43604-1531
Phone (419) 254-7841

Other identifiers 1

IdentifierTypeStateIssuer
3401587MedicaidNC

Other names 1

  • ProMedica Hospice (Raleigh) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200624002393 NC Part B Supplier - Clinic/Group Practice 2062320336 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Raleigh, NC

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

  • In Home Health, LLC

    dba ProMedica Hospice (Raleigh)

    • Hospice and Palliative Medicine (Internal Medicine) Physician
    • Raleigh, NC
    • NPI 1558006346

    O20200624002393

    Same enrollment

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Nov 1, 2023 Change of OwnershipThis provider was the seller Heartland Hospice (Raleigh)CCN 341587, NC, NPI 1982303491

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649894400000",
    "number": "1386698199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "telephone_number": "419-254-7841",
            "fax_number": "419-252-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 FALLS OF NEUSE RD",
            "address_2": "SUITE 650",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276092523",
            "telephone_number": "919-877-9959",
            "fax_number": "919-235-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NC",
            "license": "HOS2281",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3401587",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Raleigh)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.