NPIMap

Organization Active NPI

Elumina Home Health, Inc

  • Home Health Agency
  • Portsmouth, OH
National Provider Identifier
1699886382
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ELUMINA HOME HEALTH, INC
Practice address
1220 Gay St
Portsmouth, OH 45662-3460
Phone
(740) 353-1141
Fax
(740) 353-2091
NPI assigned
Aug 31, 2006
Last updated
Nov 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Authorized official

Name
Kim Ferguson
Title
SVP
Phone
(888) 860-0333

Specialties & licenses 1

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

Addresses

Primary practice location

1220 Gay St
Portsmouth, OH 45662-3460

Mailing address

1103 Schrock Rd Ste 201
Columbus, OH 43229-1179
Phone (888) 860-0333

Other identifiers 1

IdentifierTypeStateIssuer
0974058MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080306000093 OH Part A Provider - Home Health Agency 6406931179 Practice locations: Portsmouth, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699886382. Details of each certification follow.

Home health agency certification: CCN 367571

Legal name
ELUMINA HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 13, 1994
Last certification
Jan 23, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Enrollment address
1220 Gay St
Portsmouth, OH 45662-3460

Care Compare: Home health agency

Medicare Care Compare
Listed as
Hallmark Home Care IncCCN 367571 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Apr 13, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, 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
36D0887690Elumina Home Health, Inc1220 Gay Street, Portsmouth, OH 45662Certificate of waiverFeb 14, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Monad Health Cbus LLC Organization, Columbus, OH LLC 5% Or Greater Direct Ownership Interest Feb 24, 2023 100%
Monad Health Inc Organization, Columbus, OH Corporation 5% Or Greater Indirect Ownership Interest Feb 24, 2023 100%
Douglas Speelman Individual 5% Or Greater Indirect Ownership Interest Aug 1, 2024 11.88%
Bharath Pentyala Individual 5% Or Greater Indirect Ownership Interest Aug 1, 2024 11.59%
Corporate Officer Feb 24, 2023
Corporate Director Feb 24, 2023
W-2 Managing Employee Feb 24, 2023
Bhanu Gopalam Individual 5% Or Greater Indirect Ownership Interest Aug 1, 2024 9.41%
Sarah Pentyala Individual 5% Or Greater Indirect Ownership Interest Sep 8, 2025 63.37%
Corporate Officer Feb 24, 2023 63.42%
Corporate Director Feb 24, 2023 63.42%

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1699886382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 SCHROCK RD STE 201",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432291179",
            "telephone_number": "888-860-0333",
            "fax_number": "888-645-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 GAY ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623460",
            "telephone_number": "740-353-1141",
            "fax_number": "740-353-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELUMINA HOME HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "SVP",
        "authorized_official_telephone_number": "888-860-0333"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0974058",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

Verify at the official NPI Registry.