NPIMap

Organization Active NPI

In Home Health, LLC

Doing business as ProMedica Hospice (Wentzville)

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Wentzville, MO
National Provider Identifier
1518600394
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
IN HOME HEALTH, LLC
Doing business as
ProMedica Hospice (Wentzville)
Practice address
1097 Wentzville Pkwy
Wentzville, MO 63385-3537
Phone
(636) 327-4018
NPI assigned
Apr 19, 2022
Last updated
Apr 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
IN HOME HEALTH, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Authorized official

Name
Martin David Allen
Title
Sole Director
Phone
(419) 252-5734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X Primary

Addresses

Primary practice location

1097 Wentzville Pkwy
Wentzville, MO 63385-3537

Mailing address

PO Box 10086
Toledo, OH 43699-0086
Phone (567) 585-1191

Other identifiers 1

IdentifierTypeStateIssuer
822059804MedicaidMO

Other names 1

  • ProMedica Hospice (Wentzville) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Promedica Hospice Fairview24 organizations share this tax ID, including this one
Part of
Promedica Hospice Fairview

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1518600394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10086",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436990086",
            "telephone_number": "567-585-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1097 WENTZVILLE PKWY",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853537",
            "telephone_number": "636-327-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOME HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IN HOME HEALTH, LLC",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "SOLE DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "822059804",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Wentzville)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wentzville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.