In Home Health, LLC

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

Legal business name

IN HOME HEALTH, LLC

Doing business as

ProMedica Hospice (Macon)

Practice address

5400 Riverside Dr Ste 200
Macon, GA 31210-0816

Phone

(478) 477-0101

NPI assigned

Apr 19, 2022

Last updated

Apr 19, 2022By 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

Martin David Allen

Title

Sole Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ProMedica Hospice (Macon) Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Manorcare Health Services LLC

  dba ProMedica Skilled Nursing and Rehabilitation (Lely Palms)

  • Skilled Nursing Facility
  • Naples, FL
  • NPI 1366499535

  Member Of

  NPD member

All disclosed owners & managing parties 14

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

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1760125454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10086",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436990086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 RIVERSIDE DR STE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312100816",
            "telephone_number": "478-477-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "SOLE DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000848317D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Macon)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Hospice and Palliative Medicine (Internal Medicine) Physician in Macon, GA
• Providers in Macon, GA by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.