NPIMap

Organization Active NPI

Specialized Homecare Inc

Doing business as Advent Home Medical LLC

  • Durable Medical Equipment & Medical Supplies
  • Petoskey, MI
National Provider Identifier
1720495229
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SPECIALIZED HOMECARE INC
Doing business as
Advent Home Medical LLC
Practice address
3890 Charlevoix Ave Ste 160
Petoskey, MI 49770-8420
Phone
(231) 753-2700
Fax
(231) 881-9024
NPI assigned
Jul 16, 2014
Last updated
Nov 27, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECIALIZED HOMECARE ADVENTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Authorized official

Name
Carlia Cichon
Title
Owner
Phone
(877) 944-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

3890 Charlevoix Ave Ste 160
Petoskey, MI 49770-8420

Mailing address

1535 Highwood E
Pontiac, MI 48340-1234
Phone (877) 944-9800

Other identifiers 1

IdentifierTypeStateIssuer
87-4667092MedicaidMI

Other names 1

  • Advent Home Medical LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140825002553 MI DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & EquipmentDME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Registered Pharmacist 8628287604 Practice locations: Petoskey, MI

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Specialized Homecare Inc3890 Charlevoix Rd, Petoskey, MI 49770-8420(231) 753-2700 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Hospital Beds (Electric)|Hospital Beds (Manual)|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Canes and/or Crutches|Patient Lifts|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manual Related Accessories)|… Does not accept assignmentParticipating since Aug 3, 2004

National Provider Directory

National Provider Directory
Tax ID family
Specialized Homecare Inc3 organizations share this tax ID, including this one
Part of
Specialized Homecare Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732665600000",
    "number": "1720495229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 HIGHWOOD E",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483401234",
            "telephone_number": "877-944-9800",
            "fax_number": "248-409-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 CHARLEVOIX AVE STE 160",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708420",
            "telephone_number": "231-753-2700",
            "fax_number": "231-881-9024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED HOMECARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECIALIZED HOMECARE ADVENT",
        "enumeration_date": "2014-07-16",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A",
        "authorized_official_last_name": "CICHON",
        "authorized_official_first_name": "CARLIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "877-944-9800"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87-4667092",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advent Home Medical LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.