Advantage Home Health Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

007116 Issued in IN

Legal business name

ADVANTAGE HOME HEALTH CARE, INC.

Practice address

4008 N Wheeling Ave
Muncie, IN 47304-1427

Phone

(765) 284-1211

Fax

(765) 284-1239

NPI assigned

Oct 27, 2005

Last updated

Jan 11, 2010By 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

Jackie L Michael

Title

Ceo

Phone

(765) 284-1211

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407846736. Details of each certification follow.

• CCN 15K190 Home health agency · Active · Name & address match · Details

Home health agency certification: CCN 15K190

Legal name

ADVANTAGE HOME HEALTH CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 28, 1994

Last certification

Sep 16, 2001

Ownership / control type

Proprietary

Facility address

4008 Wheeling Ave
Muncie, IN 47304

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1407846736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4008 N WHEELING AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473041427",
            "telephone_number": "765-284-1211",
            "fax_number": "765-284-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 N WHEELING AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473041427",
            "telephone_number": "765-284-1211",
            "fax_number": "765-284-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-27",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-284-1211"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "007116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000098092",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WAIVER",
            "identifier": "100374780",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100374770",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.