Organization Active NPI

Community Mercy Home Care Services of Springfield, LLC

  • Home Health Agency
  • Springfield, OH
National Provider Identifier
1790779221
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
COMMUNITY MERCY HOME CARE SERVICES OF SPRINGFIELD, LLC
Practice address
1111 N Plum St Ste 5
Springfield, OH 45504-2154
Phone
(937) 328-5113
Fax
(937) 521-2305
NPI assigned
Sep 12, 2005
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Jack Hawkins
Title
VP Finance Cfo
Phone
(513) 576-8478

Owners & managing parties with NPI records 8

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

Other NPIs with the same Medicare PAC ID 1

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

Member of 2

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

Facilities with the same owner 53

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

View all 53

Affiliated clinicians 52

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

View all 52

Care Compare: Home health agency

Medicare Care Compare
Listed as
Community Mercy Home Care, LLCCCN 367447
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Jul 5, 1989
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
36D0959392Community Mercy Home Care Services1111 N Plum Street #5, Springfield, OH 45504Certificate of waiverApr 11, 2027

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040820000758 OH Part a Provider - Home Health Agency 1456325026 Practice locations: Springfield, OH

Home health agency certification: CCN 367447

Medicare enrollment files
Legal name
COMMUNITY MERCY HOME CARE SERVICES OF SPRINGFIELD, LLC
Doing business as
COMMUNITY MERCY HOME CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 5, 1989
Last certification
Dec 19, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Oct 11, 2005 in OH
Enrollment address
1111N Plum St 5
Springfield, OH 45504-2154
HHA Branch

All disclosed owners & managing parties 15

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
William C Crabtree Individual Corporate OfficerChairman/Board Member Jan 1, 2024
Health at Home Holdco, LLC Organization, Englewood, CO LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2022 33%
Commonspirit Health Organization, Englewood, CO Non-profit 5% Or Greater Indirect Ownership Interest Mar 30, 2011 100%
Commonspirit Health at Home, LLC Organization, Englewood, CO LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2022 100%
Rhonda Beane Individual Corporate DirectorBoard Member Jan 1, 2021
Cynthia a Beam Individual W-2 Managing EmployeeAd; Jan 1, 2024
Kendra Onsgard Individual Corporate DirectorCno/Board Member Jan 1, 2025
Health at Home Blocker, LLC Organization, Englewood, CO LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2022 67%
Jenelle Zelinski Individual Corporate DirectorBoard Member Jan 1, 2020
Consolidated Health Services LLC Organization, Loveland, OH LLC 5% Or Greater Indirect Ownership Interest Oct 11, 2005 100%
Thomas a. Drook Individual Corporate Director Jan 1, 2024
American Nursing Care, LLC Organization, Loveland, OH LLC 5% Or Greater Direct Ownership Interest Oct 11, 2005 50%
Benjamin Merick Individual Corporate OfficerVP Ops/Board Member Dec 15, 2021
Community Mercy Health Partners Organization, Springfield, OH For-profit 5% Or Greater Direct Ownership Interest Oct 11, 2005 50%
Jack D Hawkins Individual Corporate OfficerVP Finance & Cfo Feb 1, 2022

National Provider Directory

National Provider Directory

Locations

1111 N Plum St
Ste 5
Springfield, OH 45504
Phone (937) 328-5113

1111 N Plum St
Ste 4
Springfield, OH 45504
Phone (937) 328-5113

9963 Cincinnati Dayton Rd
West Chester, OH 45069
Phone (513) 942-3095

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

1111 N Plum St Ste 5
Springfield, OH 45504-2154

Mailing address

6281 Tri Ridge Blvd Ste 300
Loveland, OH 45140-8345
Phone (513) 576-8472

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
2269478MedicaidOH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 1, 2023.

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1790779221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6281 TRI RIDGE BLVD STE 300",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451408345",
            "telephone_number": "513-576-8472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N PLUM ST STE 5",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042154",
            "telephone_number": "937-328-5113",
            "fax_number": "937-521-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MERCY HOME CARE SERVICES OF SPRINGFIELD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "VP FINANCE CFO",
        "authorized_official_telephone_number": "513-576-8478"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2269478",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.