Organization Active NPI

Nationwide Children's Hospital Homecare

  • Home Health Agency
  • Columbus, OH
National Provider Identifier
1417955170
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
NATIONWIDE CHILDREN'S HOSPITAL HOMECARE
Practice address
255 E Main St
Columbus, OH 43215-5222
Phone
(614) 355-1100
Fax
(614) 355-1182
NPI assigned
Jul 7, 2005
Last updated
May 2, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
NATIONWIDE CHILDREN'S HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Authorized official

Name
Wanda Stackpole, RN
Title
VP Homecare
Phone
(614) 355-1100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Home Infusion Agency 251F00000X BC3288455 OH
Community Based Hospice Care Agency 251G00000X 0097-HSP OH

Addresses

Primary practice location

255 E Main St
Columbus, OH 43215-5222

Mailing address

255 E Main St
Columbus, OH 43215-5222
Phone (614) 355-1100

Other identifiers 1

IdentifierTypeStateIssuer
0842860MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Part of
Nationwide Children's Hospital Pharmacy

Locations

26 Hospital Dr
Ste 2300
Athens, OH 45701
Phone (740) 331-6341

536 S Trimble Rd
Mansfield, OH 44906
Phone (419) 528-3150

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Nationwide Children's Hospital Organization, Columbus, OH Corporation 5% Or Greater Direct Ownership Interest Apr 12, 2007 100%
Timothy Robinson Individual Corporate OfficerBoard Treasurer Apr 12, 2007
Operational/Managerial ControlBoard Treasurer Apr 12, 2007
Wanda Stackpole Individual Corporate DirectorVice President of Homecare Apr 12, 2007
Richard Miller Individual Corporate OfficerBoard President Apr 12, 2007
Operational/Managerial ControlBoard President Apr 12, 2007
Linda Stoverock Individual Corporate OfficerBoard Secretary Apr 12, 2007
Operational/Managerial ControlBoard Secretary Apr 12, 2007

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209686400000",
    "number": "1417955170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155222",
            "telephone_number": "614-355-1100",
            "fax_number": "614-355-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155222",
            "telephone_number": "614-355-1100",
            "fax_number": "614-355-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONWIDE CHILDREN'S HOSPITAL HOMECARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATIONWIDE CHILDREN'S HOSPITAL",
        "enumeration_date": "2005-07-07",
        "last_updated": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "STACKPOLE",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "VP HOMECARE",
        "authorized_official_telephone_number": "614-355-1100",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "OH",
            "license": "BC3288455",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OH",
            "license": "0097-HSP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0842860",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.