NPIMap

Organization Active NPI

Peak Home Health LLC

  • Home Health Agency
  • Merrillville, IN
National Provider Identifier
1790046795
Registry record updated Mar 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
120128881 Issued in IN
Legal business name
PEAK HOME HEALTH LLC
Practice address
8684 Connecticut St
Suite A2
Merrillville, IN 46410-5580
Phone
(219) 472-9820
Fax
(219) 472-9821
NPI assigned
Jun 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2013

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

Authorized official

Name
Ms. Gwendolyn M Oglesby Odom, RN
Title
Administrator
Phone
(219) 472-9820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 120128881 IN Primary

Addresses

Primary practice location

8684 Connecticut St
Suite A2
Merrillville, IN 46410-5580

Mailing address

8684 Connecticut St
Suite A2
Merrillville, IN 46410-5580
Phone (219) 472-9820

Other identifiers 1

IdentifierTypeStateIssuer
120128881OtherINSTATE LICENSURE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130325000220 IN Part A Provider - Home Health Agency 0648415505 Practice locations: Schererville, IN

Home health agency certification: CCN 157662

Legal name
PEAK HOME HEALTH LLC
Doing business as
ONE HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 8, 2013
Last certification
Oct 18, 2016
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
833 W Lincoln Hwy
Ste 105W
Schererville, IN 46375-1677
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
One Home Health, LLCCCN 157662
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Aug 8, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
15D2040386One Home Health LLC833 W Lincoln Hwy Suite 105W, Schererville, IN 46375Certificate of waiverApr 29, 2028

National Provider Directory

National Provider Directory

Locations

8684 Connecticut St
Ste A2
Merrillville, IN 46410
Phone (219) 472-9820

833 W Lincoln Hwy
Ste 300
Schererville, IN 46375
Phone (219) 472-9820

833 W Lincoln Hwy
Ste 105W
Schererville, IN 46375
Phone (219) 472-9820

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Thomas Davitt Individual 5% Or Greater Direct Ownership Interest Jan 1, 2020 42.5%
Simrat Singh Individual W-2 Managing Employee Sep 24, 2019
Joseph Smythe Individual 5% Or Greater Direct Ownership Interest Jan 1, 2020 16.5%
Michael J McGrail Individual 5% Or Greater Direct Ownership Interest Jan 1, 2020 12%
Operational/Managerial Control Mar 16, 2022
Christopher Cowan Individual 5% Or Greater Direct Ownership Interest Jan 1, 2020 10%
Lawrence Wert Individual 5% Or Greater Direct Ownership Interest Jan 1, 2020 17%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364169600000",
    "number": "1790046795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8684 CONNECTICUT ST",
            "address_2": "SUITE A2",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105580",
            "telephone_number": "219-472-9820",
            "fax_number": "219-472-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8684 CONNECTICUT ST",
            "address_2": "SUITE A2",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105580",
            "telephone_number": "219-472-9820",
            "fax_number": "219-472-9821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2013-03-25",
        "status": "A",
        "authorized_official_last_name": "OGLESBY ODOM",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "219-472-9820",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "120128881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE",
            "identifier": "120128881",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.