Organization Active NPI

Avid at Home LLC

  • Home Health Agency
  • Hartland, WI
National Provider Identifier
1457084097
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
AVID AT HOME LLC
Practice address
810 Cardinal LN Ste 230
Hartland, WI 53029-2390
Phone
(262) 337-4796
NPI assigned
Jul 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Authorized official

Name
Jennifer McLeodNPI 1538714324
Title
Owner/Vice President
Phone
(262) 337-4796

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

810 Cardinal LN Ste 230
Hartland, WI 53029-2390

Mailing address

810 Cardinal LN Ste 230
Hartland, WI 53029-2390
Phone (262) 337-4796

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2285853Avid at Home LLC810 Cardinal Lane, Ste 230, Hartland, WI 53029Certificate of waiverJul 18, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1457084097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 CARDINAL LN STE 230",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530292390",
            "telephone_number": "262-337-4796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 CARDINAL LN STE 230",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530292390",
            "telephone_number": "262-337-4796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVID AT HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-01",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "MCLEOD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/VICE PRESIDENT",
        "authorized_official_telephone_number": "262-337-4796"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartland, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.