Community Home Health Care Services, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

05-002684-1 Issued in IN

Legal business name

COMMUNITY HOME HEALTH CARE SERVICES, LLC

Practice address

240 Commerce SQ
Michigan City, IN 46360-3282

Phone

(219) 324-5005

Fax

(219) 736-1385

NPI assigned

May 17, 2006

Last updated

Sep 8, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Emily Fiske, RN

Title

Administrator / Don

Phone

(219) 324-5005

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689626665. Details of each certification follow.

• CCN 157533 Home health agency · Active · Details

Home health agency certification: CCN 157533

Legal name

COMMUNITY HOME HEALTH CARE SERVICES, LLC

Doing business as

HOME CARE SERVICES OF NORTHWEST INDIANA

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 29, 2001

Last certification

Sep 13, 2021

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Enrollment address

240 Commerce SQ
Michigan City, IN 46360-3282

Listed as

Home Care Services of Northwest IndianaCCN 157533 · All quality measures

Overall star rating

2.5 of 5

Ownership

Proprietary

Certified

May 29, 2001

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

Facilities with the same owner 4

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

• Clinical Management Services, Inc.

  • Home Health Agency
  • Demotte, IN
  • NPI 1306898390

  Leestma Family LP Trust, Leestma Family Trust/Ruth Leestma Grantor, The Homecare Group LLC

  CMS ownership
• Community Home Health Care of Michigan, Inc.

  • Home Health Agency
  • White Cloud, MI
  • NPI 1780638734

  The Homecare Group LLC

  CMS ownership
• Community Home Health Care of West Michigan, Inc

  • Home Health Agency
  • Norton Shores, MI
  • NPI 1477891380

  The Homecare Group LLC

  CMS ownership
• Northern Home Care Inc

  • Home Health Agency
  • White Cloud, MI
  • NPI 1841262821

  The Homecare Group LLC

  CMS ownership

Affiliated clinicians 5

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

• Rebecca Ehrick, NP

  • Family Nurse Practitioner
  • La Porte, IN
  • NPI 1356850937

  Home health agency

  Care Compare affiliation
• Nadeem U Kamran, M.D.

  • Internal Medicine Physician
  • La Porte, IN
  • NPI 1275696171

  Home health agency

  Care Compare affiliation
• Brittany Nichole Lynn

  • Family Nurse Practitioner
  • La Porte, IN
  • NPI 1578264438

  Home health agency

  Care Compare affiliation
• Deborah Michelle Pavey, MD

  • Family Medicine Physician
  • La Porte, IN
  • NPI 1417577271

  Home health agency

  Care Compare affiliation
• Vinay C Tumuluri, MD

  • Internal Medicine Physician
  • La Porte, IN
  • NPI 1528015344

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631059200000",
    "number": "1689626665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 COMMERCE SQ",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603282",
            "telephone_number": "219-324-5005",
            "fax_number": "219-736-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 COMMERCE SQ",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603282",
            "telephone_number": "219-324-5005",
            "fax_number": "219-736-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOME HEALTH CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "FISKE",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "ADMINISTRATOR / DON",
        "authorized_official_telephone_number": "219-324-5005",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "05-002684-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200323290A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Elizabeth Colella, PHARMD
• Nicole M Coleman
• David Lee Colgrove, M.D.
• Christina Marie Collazo, COTA/L
• Renee Marie Collier, O.D.
• Compass Life Indiana LLC
• Marcos Contreras
• Contri Medical Corporation PC
• Danielle Lashon Corley, PMHNP
• Cornerstone Caregiving East LLC

• Home Health Agency in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Home Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.