NPIMap

Organization Active NPI

Nivalis Health LLC

  • Community Based Hospice Care Agency
  • Westlake, OH
National Provider Identifier
1659885135
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
0248HSP Issued in OH
Legal business name
NIVALIS HEALTH LLC
Practice address
915 Bassett Road
Westlake, OH 44145-1108
Phone
(440) 462-2600
Fax
(440) 250-8670
NPI assigned
Nov 20, 2017
Last updated
Apr 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
Shannan S Reznik
Title
Business Office Manager
Phone
(330) 571-2925

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 0248HSP OH Primary

Addresses

Primary practice location

915 Bassett Road
Westlake, OH 44145-1108

Mailing address

915 Bassett Road
Westlake, OH 44145-1108
Phone (440) 462-2600

Other identifiers 1

IdentifierTypeStateIssuer
0331674MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180406000780 OH Part A Provider - Hospice 8022371962 Practice locations: Westlake, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659885135. Details of each certification follow.

Hospice certification: CCN 361705

Legal name
NIVALIS HEALTH LLC
Doing business as
NIVALIS HEALTH LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 16, 2018
Last certification
Jul 16, 2018
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Feb 3, 2017 in OH
Enrollment address
915 Bassett Rd
Westlake, OH 44145-1108

Care Compare: Hospice

Medicare Care Compare
Listed as
Nivalis HospiceCCN 361705 · All quality measures
Ownership
For-Profit
Certified
Jul 16, 2018
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Gasan Nemr Individual Contracted Managing EmployeeMedical Director Aug 30, 2017
Shannan S Reznik Individual W-2 Managing EmployeeOffice Manager Aug 10, 2018
Kelly Barcik Individual W-2 Managing EmployeeAdministrator Dec 5, 2017
Susan Griffiths Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2020 100%
Transcendent, LLC Organization, Bay Village, OH LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Dec 31, 2020 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 6

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 7

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": "1511136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1659885135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 BASSETT ROAD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451108",
            "telephone_number": "440-462-2600",
            "fax_number": "440-250-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 BASSETT ROAD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451108",
            "telephone_number": "440-462-2600",
            "fax_number": "440-250-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIVALIS HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-20",
        "last_updated": "2022-04-27",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "REZNIK",
        "authorized_official_first_name": "SHANNAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "330-571-2925"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OH",
            "license": "0248HSP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0331674",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.