NPIMap

Organization Active NPI

Shepherd of the Valley Lutheran Retirement Services, Inc.

Doing business as At Home With Shepherd

  • Home Health Agency
  • Austintown, OH
National Provider Identifier
1609960350
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.
Doing business as
At Home With Shepherd
Practice address
5525 Silica Road
Austintown, OH 44515-1002
Phone
(330) 530-4038
Fax
(330) 530-4039
NPI assigned
Oct 3, 2006
Last updated
Aug 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Authorized official

Name
Victoria N. Brown
Title
Associate Director/Cfo
Phone
(330) 530-4038

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

5525 Silica Road
Austintown, OH 44515-1002

Mailing address

5525 Silica Road
Austintown, OH 44515-1002
Phone (330) 530-4038

Other names 1

  • At Home With Shepherd Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120327000739 OH Part A Provider - Home Health Agency 2961310180 Practice locations: Austintown, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609960350. Details of each certification follow.

Home health agency certification: CCN 367741

Legal name
SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.
Doing business as
AT HOME WITH SHEPHERD
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 16, 1997
Last certification
Nov 30, 2017
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Jan 3, 1972 in OH
Enrollment address
5525 Silica Road
Austintown, OH 44515-1002
HHA Branch

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
At Home With ShepherdCCN 367741 · All quality measures
Overall star rating
3.5 of 5
Ownership
Non-Profit
Certified
May 16, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
36D0931305At Home With Shepherd5525 Silica Road, Austintown, OH 44515Certificate of waiverJul 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Shepherd of the Valley Lutheran Retirement Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Giuseppe B Deabate Individual Corporate OfficerPresident Jan 1, 2020
Corporate Director Jan 1, 2019
Robert Quaintance Individual Corporate OfficerSecretary Jan 1, 2023
Corporate DirectorDirector Jan 1, 2023
Shepherd of the Valley Lutheran Retirement Services, Inc. Organization, Austintown, OH Non-profit 5% Or Greater Indirect Ownership Interest Jan 3, 1972
Richard Limongi Individual Corporate Director Jan 1, 2015
W-2 Managing EmployeeExecutive Director Jan 1, 2015
Richard Thompson Individual Corporate OfficerTreasurer Jan 1, 2019
Corporate Director Jan 1, 2019
Paul Adamic Individual Corporate OfficerCfo Jun 20, 2022
Chrisitne Filip Individual W-2 Managing EmployeeAccounting Director Nov 23, 2011
Operational/Managerial ControlAccounting Director Aug 10, 1999
Adam Earnheardt Individual Corporate OfficerVice President Jan 1, 2020
Corporate DirectorDirector Jan 1, 2020

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Shepherd of the Valley LibertyGirard, OH, CCN 365298 Skilled nursing facility Operational/Managerial Control Jan 1, 2017
Shepherd of the Valley PolandPoland, OH, CCN 366453 Skilled nursing facility Operational/Managerial Control Jan 1, 2017

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 12

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1609960350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 SILICA ROAD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445151002",
            "telephone_number": "330-530-4038",
            "fax_number": "330-530-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 SILICA ROAD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445151002",
            "telephone_number": "330-530-4038",
            "fax_number": "330-530-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR/CFO",
        "authorized_official_telephone_number": "330-530-4038"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "At Home With Shepherd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austintown, OH

Sources for this page

Verify at the official NPI Registry.