Canary Home Health Care of Indiana Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CANARY HOME HEALTH CARE OF INDIANA INC

Practice address

9111 Broadway Ste I
Merrillville, IN 46410-8122

Phone

(219) 333-8498

NPI assigned

Apr 24, 2022

Last updated

Apr 24, 2022By 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

Mr. Braniff Laster

Title

Administrator

Phone

(219) 333-8498

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 1508500794. Details of each certification follow.

• CCN 157725 Home health agency · Active · Details

Home health agency certification: CCN 157725

Legal name

CANARY HOME HEALTH CARE OF INDIANA INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 16, 2023

Last certification

Oct 5, 2023

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Feb 8, 2022 in IN

Enrollment address

9247 Broadway
Ste a
Merrillville, IN 46410-7093

Listed as

Canary Home Healthcare of Indiana IncCCN 157725 · All quality measures

Ownership

-

Certified

Oct 16, 2023

Medicare certification status

ActiveFrom the Provider of Services file

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 2

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

Affiliated clinicians 2

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

• Jose Luis Agusti, M.D.

  • Internal Medicine Physician
  • Winfield, IN
  • NPI 1033192604

  Home health agency

  Care Compare affiliation
• Erin Wright, NP-C

  • Family Nurse Practitioner
  • Merrillville, IN
  • NPI 1346914884

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1650758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650758400000",
    "number": "1508500794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9111 BROADWAY STE II",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 BROADWAY STE I",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108122",
            "telephone_number": "219-333-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANARY HOME HEALTH CARE OF INDIANA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-24",
        "last_updated": "2022-04-24",
        "certification_date": "2022-04-24",
        "status": "A",
        "authorized_official_last_name": "LASTER",
        "authorized_official_first_name": "BRANIFF",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "219-333-8498",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Merrillville, IN
• Providers in Merrillville, 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 Apr 24, 2022; 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.