Organization Active NPI

Andventure, LLC

Doing business as Aveanna Healthcare

  • Home Health Agency
  • State College, PA
National Provider Identifier
1760621122
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ANDVENTURE, LLC
Doing business as
Aveanna Healthcare
Practice address
1631 S Atherton St Ste 201
State College, PA 16801-6229
Phone
(814) 235-9583
NPI assigned
Feb 9, 2009
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Matthew Buckhalter
Title
Cfo
Phone
(470) 464-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1631 S Atherton St Ste 201
State College, PA 16801-6229

Mailing address

400 Interstate North Pkwy SE Ste 1600
Atlanta, GA 30339-5047
Phone (470) 464-8000

Other names 1

  • Aveanna Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090326000135 PA Part A Provider - Home Health Agency 6406764042 Practice locations: State College, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760621122. Details of each certification follow.

Home health agency certification: CCN 397756

Legal name
ANDVENTURE, LLC
Doing business as
AVEANNA HEALTHCARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 15, 2001
Last certification
Feb 18, 2016
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Dec 31, 2020 in PA
Enrollment address
1631 S Atherton St
Ste 201
State College, PA 16801-6229

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Aveanna HealthcareCCN 397756 · All quality measures
Ownership
Proprietary
Certified
Nov 15, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide

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
39D1099928Andventure, LLC Dba Aveanna Healthcare1631 S Atherton Street, Suite 201, State College, PA 16801Certificate of waiverMay 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Andventure LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1631 S Atherton St
Ste 201
State College, PA 16801
Phone (814) 235-9583

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
J.H. Whitney VII LP Organization, New Canaan, CT For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 16.09%
Psa Healthcare Investment Holding LLC Organization, New Canaan, CT LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 8.04%
Aveanna Healthcare LLC Organization, Atlanta, GA LLC, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 31, 2020 100%
Aveanna Healthcare Intermediate Holdings LLC Organization, Atlanta, GA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 100%
Aveanna Healthcare Holdings Inc Organization, Atlanta, GA Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 100%
Nut Tree Master Fund LP Organization, New York, NY For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 31, 2023 6.34%
Matthew Buckhalter Individual Corporate OfficerCfo Jul 7, 2023
Corporate DirectorCfo Jul 7, 2023
Bcip Associates IV US L.P. Organization, Boston, MA For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 5.35%
Kelsey Gulish Individual W-2 Managing EmployeeAd; Aug 10, 2021
Hamilton Lane Co-Investment Fund III Holdings - 2 LP Organization, Bala Cynwyd, PA For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 7.5%
Deborah Stewart Individual Corporate DirectorDirector Jul 7, 2023
Bain Capital Fund XI LP Organization, Boston, MA For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 35.54%
Jerrold Perchik Individual Corporate OfficerSecretary Apr 29, 2024
Bcpe Eagle Investor, L.P. Organization, Boston, MA Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 29, 2021 41.83%
Jeffrey Shaner Individual Corporate OfficerCeo Mar 16, 2017
Corporate DirectorCeo Jan 1, 2023
Pea Washington Holdings, LP Organization, George Town For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 29, 2021 5.45%

Facilities with the same owner 122

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

View all 122

NPI Registry JSON

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1760621122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERSTATE NORTH PKWY SE STE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395047",
            "telephone_number": "470-464-8000",
            "fax_number": "770-248-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 S ATHERTON ST STE 201",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168016229",
            "telephone_number": "814-235-9583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDVENTURE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-09",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "BUCKHALTER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "470-464-8000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.