Majestic Home Health LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MAJESTIC HOME HEALTH LLC

Practice address

777 E Main St Ste 211
Westfield, IN 46074-5300

Phone

(317) 625-5668

NPI assigned

Jun 25, 2021

Last updated

Jul 20, 2023By 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

Paul Pruitt

Title

Chief Executive Officer

Phone

(317) 288-4029

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417527235. Details of each certification follow.

• CCN 157670 Home health agency · Active · Details

Home health agency certification: CCN 157670

Legal name

MAJESTIC HOME HEALTH LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 26, 2014

Last certification

Jun 26, 2014

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

May 24, 2021 in IN

Enrollment address

777 E Main St
Westfield, IN 46074-5300

Listed as

Majestic Home Health LLCCCN 157670 · All quality measures

Overall star rating

1.5 of 5

Ownership

Proprietary

Certified

Jun 26, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

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

CLIA laboratory certificates

All disclosed owners & managing parties 8

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Robert Laron Russell, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Carmel, IN
  • NPI 1407052376

  Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Change-of-ownership history 1

Change of ownership 1

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

• Paradigm Living Concepts, LLC

  dba Paradigm Health

  • Home Health Agency
  • Indianapolis, IN
  • NPI 1316370612

  Acquired from, 2021-06-18

  CMS change of ownership

Affiliated clinicians 1

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

• Pragneshkumar N Radadiya, MD

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1548421985

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1417527235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E MAIN ST STE 211",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460745300",
            "telephone_number": "317-288-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E MAIN ST STE 211",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460745300",
            "telephone_number": "317-625-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJESTIC HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-25",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "317-288-4029"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donyae Maclin
• Celine Maduwuba
• Charles U Maduwuba, PT, MHSPT
• Taurai Magombo
• Linda Mahoney, ATC
• Daphne Christine Maligaya
• Rachel Lyn Malonjao
• Anah Mae Mamay
• Shirley Manacsa, PT
• Paige Mangum

• Home Health Agency in Westfield, IN
• Providers in Westfield, IN by specialty
• Home Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.