NPIMap

Organization Active NPI

Hoosier Homecare Services, LLC

  • Home Health Agency
  • Anderson, IN
National Provider Identifier
1801075049
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
HOOSIER HOMECARE SERVICES, LLC
Practice address
614 E 53Rd St
Anderson, IN 46013-1727
Phone
(765) 622-1000
Fax
(765) 622-1002
NPI assigned
Oct 24, 2007
Last updated
Apr 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Authorized official

Name
Mr. Christopher Eugene Daggy, MSOTR
Title
Administrator
Phone
(765) 622-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

614 E 53Rd St
Anderson, IN 46013-1727

Mailing address

614 E 53Rd St
Anderson, IN 46013-1727
Phone (765) 622-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080502000279 IN Part A Provider - Home Health Agency 9335228394 Practice locations: Anderson, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801075049. Details of each certification follow.

Home health agency certification: CCN 157608

Legal name
HOOSIER HOMECARE SERVICES, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 15, 2009
Last certification
Aug 23, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
614 East 53Rd Street
Anderson, IN 46013-1727

Care Compare: Home health agency

Medicare Care Compare
Listed as
Hoosier Homecare Services LLCCCN 157608 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
May 15, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, 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
15D1086805Hoosier Homecare Services LLC614 E 53Rd St, Anderson, IN 46013Certificate of waiverJul 17, 2028

National Provider Directory

National Provider Directory

Locations

1240 Meridian St
Anderson, IN 46016
Phone (765) 622-1000

614 E 53rd St
Anderson, IN 46013
Phone (765) 622-1000

12220 N Meridian St
Ste 165
Carmel, IN 46032
Phone (317) 752-9182

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Cheryan Cheryan Individual Corporate OfficerAdministrator Apr 2, 2024 10%
W-2 Managing EmployeeAd; Apr 3, 2023 30%
Operational/Managerial ControlAdministrator Apr 2, 2024 30%
Patricia Mikesell Individual Corporate OfficerBoard Member Aug 28, 2007
W-2 Managing EmployeeAd; Apr 3, 2024
Lidia Kedziora Individual 5% Or Greater Direct Ownership Interest Aug 28, 2007 50%
General Partnership InterestAsst Administrator/Partner Aug 28, 2007 50%
Corporate OfficerAsst Administrator/Partner Aug 28, 2007 50%
Corporate DirectorAsst Administrator/Partner Aug 28, 2007 50%
Operational/Managerial ControlAsst Administrator Aug 28, 2007 50%
Christopher Daggy Individual 5% Or Greater Direct Ownership Interest Oct 23, 2007 50%
General Partnership InterestPartner Aug 28, 2007 50%
Corporate OfficerPartner Aug 28, 2007 50%
Corporate DirectorAdministrator/Partner Aug 28, 2007 50%
Operational/Managerial ControlPartner Aug 28, 2007 50%

Practitioners & affiliated clinicians

Affiliated clinicians 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1801075049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 E 53RD ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460131727",
            "telephone_number": "765-622-1000",
            "fax_number": "765-622-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 E 53RD ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460131727",
            "telephone_number": "765-622-1000",
            "fax_number": "765-622-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOOSIER HOMECARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "DAGGY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "765-622-1000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSOTR"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.