NPIMap

Organization Active NPI

Maggie'S Home Health, LLC

  • Home Health Agency
  • Cottonwood, AZ
National Provider Identifier
1740925148
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MAGGIE'S HOME HEALTH, LLC
Practice address
203 S Candy LN Ste 12a
Cottonwood, AZ 86326-8114
Phone
(928) 496-6500
Fax
(928) 496-6501
NPI assigned
Apr 29, 2022
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Cassandra Armenise
Title
Director of Operations
Phone
(602) 889-4400

Facilities with the same owner 3

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

Affiliated clinicians 19

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Maggie'S Home Health LLCCCN 037821
Overall star rating
2.5 of 5
Ownership
-
Certified
Nov 1, 2022
Medicare certification status
Active (Provider of Services file)

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
03D2263347Maggie'S Home Health, LLC203 S Candy Lane #12a, Cottonwood, AZ 86326Certificate of waiverJun 26, 2028

Medicare participation

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

Home health agency certification: CCN 037821

Medicare enrollment files
Legal name
MAGGIE'S HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 1, 2022
Last certification
Oct 27, 2022
Organization structure
LLCProprietary
Enrollment address
203 S Candy LN
Ste 12a
Cottonwood, AZ 86326-8114

All disclosed owners & managing parties 8

Medicare enrollment files

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

NameRoleSinceShare
Drew Colburn Individual W-2 Managing EmployeeAd; Feb 1, 2024 100%
James S Kerrigan Individual Corporate DirectorBoard Member Sep 22, 2021
Thema Health, Inc Organization, Brentwood, TN Created for acquisition, Corporation 5% Or Greater Direct Ownership Interest Sep 22, 2021 100%
Cassandra N Armenise Individual Corporate DirectorDirector of Operations Aug 1, 2023 100%
W-2 Managing EmployeeDirector of Operations Aug 1, 2023 100%
James W Phillips Individual Corporate OfficerSecretary Sep 22, 2021
Corporate DirectorBoard Member Sep 22, 2021
Joshua Gantner Individual Corporate OfficerChief Growth Officer Aug 1, 2023
W-2 Managing EmployeeChief Growth Officer Aug 1, 2023 100%
Lori Steblein Individual Corporate DirectorDirector of HR and Compliance Aug 1, 2023 100%
W-2 Managing EmployeeDirector of HR and Compliance Aug 1, 2023 100%
Anna V Kovalkova Individual Corporate Director Sep 22, 2021

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20220602000040 AZ Part a Provider - Home Health Agency 6406234525 Practice locations: Cottonwood, AZ

National Provider Directory

National Provider Directory

Locations

203 S Candy Ln
Ste 12A
Cottonwood, AZ 86326
Phone (928) 496-6500

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

203 S Candy LN Ste 12a
Cottonwood, AZ 86326-8114

Mailing address

1725 E Osborn Rd
Phoenix, AZ 85016-7123
Phone (602) 889-4400

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 29, 2023.

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1740925148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 E OSBORN RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167123",
            "telephone_number": "602-889-4400",
            "fax_number": "602-216-6112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S CANDY LN STE 12A",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863268114",
            "telephone_number": "928-496-6500",
            "fax_number": "928-496-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGGIE'S HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-29",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "ARMENISE",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "602-889-4400"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

Verify at the official NPI Registry.