Organization Active NPI

Crossway Homecare LLC

  • Home Health Agency
  • North Andover, MA
National Provider Identifier
1730556556
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CROSSWAY HOMECARE LLC
Practice address
30 Ma Ave
Suite 306 B
North Andover, MA 01845-3458
Phone
(978) 390-0958
NPI assigned
Aug 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Authorized official

Name
Shannon Njoroge
Title
Treasurer
Phone
(978) 390-0958

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

30 Ma Ave
Suite 306 B
North Andover, MA 01845-3458

Mailing address

30 Ma Ave
Suite 306 B
North Andover, MA 01845-3458
Phone (978) 390-0958

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150929002746 MA Part A Provider - Home Health Agency 4880902568 Practice locations: North Andover, MA

Home health agency certification: CCN 227648

Legal name
CROSSWAY HOMECARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 18, 2016
Last certification
May 18, 2016
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Aug 27, 2015 in MA
Enrollment address
30 Massachusetts Ave
Ste 405
North Andover, MA 01845-3458

Care Compare: Home health agency

Medicare Care Compare
Listed as
Crossway Homecare LLCCCN 227648 · All quality measures
Overall star rating
1 of 5
Ownership
Proprietary
Certified
May 18, 2016
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

30 Massachusetts Ave
Ste 405
North Andover, MA 01845
Phone (978) 390-0958

30 Massachusetts Ave
Ste 306
North Andover, MA 01845
Phone (978) 390-0958

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
John Njoroge Individual 5% Or Greater Direct Ownership Interest Aug 27, 2015 25%
Corporate OfficerPresident Aug 27, 2015 25%
Corporate DirectorPresident Aug 27, 2015 25%
W-2 Managing EmployeePresident Aug 27, 2015 25%
Simon Gitau Individual 5% Or Greater Direct Ownership Interest Aug 27, 2015 25%
Corporate OfficerVice President Aug 27, 2015 25%
Corporate DirectorVice President Aug 27, 2015 25%
W-2 Managing EmployeeVice President Aug 27, 2015 25%
Shannon Njoroge Individual 5% Or Greater Direct Ownership Interest Aug 27, 2015 25%
Corporate OfficerTreasurer Aug 27, 2015 25%
Corporate DirectorTreasurer Aug 27, 2015 25%
W-2 Managing EmployeeTreasurer Aug 27, 2015 25%

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1730556556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MA AVE",
            "address_2": "SUITE 306 B",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018453458",
            "telephone_number": "978-390-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MA AVE",
            "address_2": "SUITE 306 B",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018453458",
            "telephone_number": "978-390-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSWAY HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "NJOROGE",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "978-390-0958"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

Verify at the official NPI Registry.