Aunova Home Care, LLC
Organization Active NPI Home Health Agency · Granger, IN
NPI 1679969489 · NPPES record last updated Aug 15, 2018
Key facts
- NPI
- 1679969489
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 15-013602 (IN)
- Legal business name
- AUNOVA HOME CARE, LLC
- Practice address
- 6910 N Main St
Suite 23a
Granger, IN 46530 - Phone
- (574) 243-9021
- Fax
- (574) 243-9023
- NPI assigned
- Apr 8, 2015
- Organization subpart
- No
Authorized official
- Name
- Swati Douglas
- Title
- Administrator
- Phone
- (574) 243-9021
Affiliated clinicians 19
-
Pavan Ahuja, M.D.
-
William P Buckley, M.D.
-
Mary Elizabeth Campbell, MD, MPH
-
Joseph Michael Caruso, M.D.
-
Adam Joseph Cien, D.O.
-
Ebonee L Davis, MD
-
Jeffrey S Howe, M.D.
-
Brian M Huber, MD
-
Megan Lee Mace, PA-C, ATC
-
Robert S Oppman, MD
-
Kamran Fasih Siddiqui, M.D.
-
Thomas R. Vidic, M.D.
-
John A Whitney, MD
-
Sidrah Zaidi, MD
Medicare Care Compare: Home health agency
- Listed as
- Aunova Home Care LLC
- Overall star rating
- ★★★★☆ 4 of 5
- Ownership
- Proprietary
- Certified
- Dec 30, 2015
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D2100924 | Aunova Home Care, LLC | Certificate of waiver | Aug 24, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Home health agency certification: CCN 157683
- Legal name
- AUNOVA HOME CARE LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 30, 2015
- Last certification
- Dec 30, 2015
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Jul 15, 2014 in IN
- Enrollment address
- 6910 N Main St
Suite 23a
Granger, IN 46530-8845
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Swati Douglas |
5% Or Greater Direct Ownership Interest |
Aug 7, 2021 | 100% |
| Corporate Officer |
Aug 7, 2021 | 100% | |
| Corporate Director |
Aug 7, 2021 | 100% | |
| W-2 Managing Employee |
Mar 10, 2023 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150821013413 | IN | Part a Provider - Home Health Agency | 8628383528 | Practice locations: Granger, IN |
National Provider Directory
Locations
6910 N Main St
Ste 23A
Granger, IN 46530
Phone (574) 243-9021
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 15-013602 | IN | Yes |
Addresses
Primary practice location
6910 N Main St
Suite 23a
Granger, IN 46530
Mailing address
6910 N Main St
Suite 23a
Granger, IN 46530-9680
Phone (574) 243-9021
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- Natali M Balog
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All providers in Granger, IN · Home Health Agency in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.