NPIMap

Organization Active NPI

In Home Health, LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • White Bear Lake, MN
National Provider Identifier
1558072017
Registry record updated Dec 6, 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
Practice address
3580 Linden Ave Ste a-1
White Bear Lake, MN 55110-4625
Phone
(651) 633-6522
NPI assigned
Dec 6, 2022
Organization subpart
Yes
Parent organization
IN HOME HEALTH, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X Primary

Addresses

Primary practice location

3580 Linden Ave Ste a-1
White Bear Lake, MN 55110-4625

Mailing address

333 N Summit St
Toledo, OH 43604-1531
Phone (567) 585-1191

Other identifiers 2

IdentifierTypeStateIssuer
091318900MedicaidMN
1134173446MedicaidWI

Other names 1

  • ProMedica Hospice (Minneapolis) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
In Home Health Inc24 organizations share this tax ID, including this one
Part of
In Home Health Inc

Other organizations with this tax ID 23

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

View all 23

Locations

3580 Linden Ave
Ste A1
White Bear Lk, MN 55110
Phone (651) 633-6522

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1558072017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "telephone_number": "567-585-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 LINDEN AVE STE A-1",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551104625",
            "telephone_number": "651-633-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOME HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IN HOME HEALTH, LLC",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091318900",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134173446",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Minneapolis)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in White Bear Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.