NPIMap

Organization Active NPI

CNS Homecare, Inc.

  • Home Health Agency
  • Troy, MI
National Provider Identifier
1639394455
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CNS HOMECARE, INC.
Practice address
1920 Livernois Rd
Troy, MI 48083-1732
Phone
(248) 649-6200
Fax
(248) 649-6221
NPI assigned
Apr 16, 2007
Last updated
Sep 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Authorized official

Name
Mrs. Pamela Marie Davis
Title
Administrator
Phone
(248) 649-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1920 Livernois Rd
Troy, MI 48083-1732

Mailing address

1920 Livernois Rd
Troy, MI 48083-1732
Phone (248) 649-6200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070828000615 MI Part A Provider - Home Health Agency 3476645987 Practice locations: Troy, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639394455. Details of each certification follow.

Home health agency certification: CCN 237750

Legal name
CNS HOMECARE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 2, 2008
Last certification
Feb 13, 2014
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 30, 2007 in MI
Enrollment address
1920 Livernois Rd
Troy, MI 48083-1770

Care Compare: Home health agency

Medicare Care Compare
Listed as
CNS Homecare, IncCCN 237750 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Jun 2, 2008
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
23D1066282CNS Homecare Inc1920 Livernois, Troy, MI 48083Certificate of waiverMar 20, 2027

National Provider Directory

National Provider Directory

Locations

2605 Crooks Rd
Troy, MI 48084
Phone (248) 649-6200

25500 Sherwood Ave
Ste A
Warren, MI 48091
Phone (248) 649-6200

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Michael C Davis Individual Corporate DirectorMedical Director Mar 30, 2007
Suzanne K Srock Individual Corporate DirectorDirector of Nursing Dec 1, 2012
Pamela M Davis Individual 5% Or Greater Direct Ownership Interest Mar 30, 2007 100%
Corporate OfficerAdministrator/Ceo Mar 30, 2007 100%
W-2 Managing EmployeeAdministrator/Ceo Mar 30, 2007 100%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 10

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": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1639394455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 LIVERNOIS RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831732",
            "telephone_number": "248-649-6200",
            "fax_number": "248-649-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 LIVERNOIS RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831732",
            "telephone_number": "248-649-6200",
            "fax_number": "248-649-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CNS HOMECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-649-6200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.