Serenity Plus Home Health Inc.
Organization Active NPI Home Health Agency · Mt Vernon, TX
NPI 1508009903 · NPPES record last updated Dec 20, 2021
Key facts
- NPI
- 1508009903
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 012871 (TX)
- Legal business name
- SERENITY PLUS HOME HEALTH INC.
- Practice address
- 106 Houston St N
Mt Vernon, TX 75457 - Phone
- (903) 270-6292
- Fax
- (903) 201-6766
- NPI assigned
- Apr 14, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Radhakrishnan Panicker
- Title
- Alt Administrator
- Phone
- (214) 455-8630
Affiliated clinicians 4
-
Jared B Petty, DO
Medicare Care Compare: Home health agency
- Listed as
- Serenity Plus Home Health Inc
- Overall star rating
- ★★☆☆☆ 2 of 5
- Ownership
- Proprietary
- Certified
- Jan 30, 2012
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Home health agency certification: CCN 747707
- Legal name
- SERENITY PLUS HOME HEALTH INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jan 30, 2012
- Last certification
- Jan 22, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Feb 9, 2009 in TX
- Enrollment address
- 106 Houston St N
Mt Vernon, TX 75457
All disclosed owners & managing parties 6
| Name | Role | Since | Share |
|---|---|---|---|
| Chad Wardrup |
5% Or Greater Direct Ownership Interest |
May 27, 2020 | 20% |
| W-2 Managing Employee |
Aug 24, 2019 | 75% | |
| Operational/Managerial Control |
Aug 24, 2019 | 90% | |
| Sandeep R Nair |
5% Or Greater Direct Ownership Interest | Aug 14, 2013 | 55% |
| Corporate Officer |
Aug 14, 2013 | 55% | |
| Corporate Director |
Aug 14, 2013 | 55% | |
| W-2 Managing Employee |
Aug 14, 2013 | 55% | |
| Operational/Managerial Control |
Aug 14, 2013 | 55% | |
| Other |
Aug 14, 2013 | 55% | |
| Jennifer Crump |
Operational/Managerial Control |
Aug 9, 2019 | 5% |
| Mallika Radhakrishnan |
5% Or Greater Direct Ownership Interest | Oct 15, 2009 | |
| Corporate Director |
Oct 15, 2009 | 25% | |
| W-2 Managing Employee |
Dec 16, 2013 | 25% | |
| Radhakrishnan Panicker |
Corporate Officer |
Aug 14, 2013 | 10% |
| W-2 Managing Employee |
Aug 14, 2013 | 10% | |
| Operational/Managerial Control |
Aug 14, 2013 | 10% | |
| Nita Rene Stephens |
W-2 Managing Employee |
Nov 11, 2019 | 10% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091207000099 | TX | Part a Provider - Home Health Agency | 7214076173 | Practice locations: Mt Vernon, TX |
National Provider Directory
Locations
401 Kaufman St N
Mt Vernon, TX 75457
5200 Paige Rd
Ste 403
The Colony, TX 75056
Phone (214) 250-7744
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| Home Health Agency | 251E00000X | 012871 | TX | Yes |
Addresses
Primary practice location
106 Houston St N
Mt Vernon, TX 75457
Mailing address
5200 Paige Rd
Suite 403
The Colony, TX 75056-2121
Phone (214) 250-7744
Other practice location 1
5200 Paige Rd
Suite 403
The Colony, TX 75056-2121
Phone (214) 250-7744
Other providers in Mt Vernon, TX
- Richard Trent Rehnquist
- Renewed Hope Mental Health PC
- Katie Lynn Roberts
- Rule Pediatric Therapy Services
- Rule Pediatric Therapy Services
- Kassie R Songer
- Stratford Hospital District
- Strive Rehabilitation
- Supportive Shores: Family & Therapy Services
- Terry Haven Nursing and Rehabilitation LP
All providers in Mt Vernon, TX · Home Health Agency in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.