Interim Healthcare of Western Pennsylvania Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

INTERIM HEALTHCARE OF WESTERN PENNSYLVANIA INC

Practice address

127 N Brady St
Suite B
Du Bois, PA 15801-2257

Phone

(814) 375-9615

Fax

(814) 375-1362

NPI assigned

Aug 25, 2005

Last updated

May 3, 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

Alisha M Heindl, RNNPI 1518415819

Title

Director/Manager

Phone

(814) 375-9615

Specialties & licenses 1

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417940487. Details of each certification follow.

• CCN 397647 Home health agency · Active · Details

Home health agency certification: CCN 397647

Legal name

INTERIM HEALTHCARE OF WESTERN PENNSYLVANIA, INC.

Doing business as

INTERIM HEALTHCARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Sep 6, 1995

Last certification

Aug 28, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Mar 1, 1992 in PA

Enrollment address

127 N Brady St
Du Bois, PA 15801-2227

Listed as

Interim Healthcare of Western PACCN 397647 · All quality measures

Ownership

Proprietary

Certified

Sep 6, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, 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

Locations

All disclosed owners & managing parties 3

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

Practitioners 4

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.

• Alisha Heindl

  • Registered Nurse
  • Kersey, PA
  • NPI 1518415819
  NPD Authorized official
• George M Fatula Jr., DPT

  • Physical Therapist
  • Du Bois, PA
  • NPI 1407073455
  NPD (past)
• Sharon Christine Johnson, PT

  • Physical Therapist
  • Du Bois, PA
  • NPI 1326264045
  NPD (past)
• Crystal L Moore, MS CCC-SLP

  • Speech-Language Pathologist
  • Du Bois, PA
  • NPI 1467633958
  NPD (past)

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1417940487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 N BRADY ST",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012227",
            "telephone_number": "814-375-9615",
            "fax_number": "814-375-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 N BRADY ST",
            "address_2": "SUITE B",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012257",
            "telephone_number": "814-375-9615",
            "fax_number": "814-375-1362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "187 Northpointe Blvd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "PA",
            "postal_code": "162292623",
            "country_code": "US",
            "telephone_number": "724-540-5057",
            "fax_number": "724-540-5941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "191 Howard St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "PA",
            "postal_code": "163232387",
            "country_code": "US",
            "telephone_number": "814-670-0588",
            "fax_number": "814-493-8476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERIM HEALTHCARE OF WESTERN PENNSYLVANIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-25",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "HEINDL",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR/MANAGER",
        "authorized_official_telephone_number": "814-375-9615",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10000084500008",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000008450012",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105044",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1511022",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLEAR-JEFF MHMR (HS)",
            "identifier": "008518",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLEAR-JEFF MHMR (HS)",
            "identifier": "008501",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000008450013",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VENANGO COUNTY MH/MR",
            "identifier": "61-34",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLEAR-JEFF MHMR (EI)",
            "identifier": "008509",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000008450010",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000008450005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1065",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Lee Ignatius, DO
• Nicole Ignatius, D.O.
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• Pamela L Ingram, CRNP
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• Suzanne Marie Iorfido, DO
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• Kaitlin Ireland, BA

• Home Health Agency in Du Bois, PA
• Providers in Du Bois, PA by specialty
• Home Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.