Active NPI
Nina'S Health Care New Lex,Inc
- Home Health Agency
- New Lexington, OH
National Provider Identifier
1821562059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- NINA'S HEALTH CARE NEW LEX,INC
- Practice address
- 445 W Broadway St
New Lexington, OH 43764-1097 - Phone
- (740) 343-4153
- NPI assigned
- Jan 22, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Grace Fongod
- Title
- Board Chair
- Phone
- (614) 314-5416
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
445 W Broadway St
New Lexington, OH 43764-1097
Mailing address
6455 E Livingston Ave
Reynoldsburg, OH 43068-3589
Phone (614) 314-5416
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200320002292 | OH | Part A Provider - Home Health Agency | 6608204839 | Practice locations: New Lexington, OH |
Home health agency certification: CCN 369297
- Legal name
- NINA'S HEALTH CARE NEW LEX,INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 17, 2021
- Last certification
- Dec 7, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Jan 21, 2019 in OH
- Enrollment address
- 445 W Broadway St
New Lexington, OH 43764-1097
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Nina'S Health Care New Lex Inc
- Ownership
- Proprietary
- Certified
- Dec 17, 2021
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider Directory- Tax ID family
- Nina'S Health Care New Lexinc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Registered Nurse
- New Lexington, OH
- NPI 1154244796
-
- Home Health Agency
- New Lexington, OH
- NPI 1629850102
Locations
115 N Main St
New Lexington, OH 43764
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Grace Fongod | Corporate Officer | Aug 30, 2023 | 100% |
| Corporate Director | Aug 30, 2023 | 100% | |
| W-2 Managing Employee | Aug 30, 2023 | 100% | |
| Emade N Ekukole-Sone | 5% Or Greater Direct Ownership Interest | Aug 30, 2023 | 100% |
| Corporate Officer | May 9, 2019 | 100% | |
| Corporate Director | May 9, 2019 | 100% | |
| W-2 Managing Employee | May 9, 2019 | 100% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698883200000",
"number": "1821562059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6455 E LIVINGSTON AVE",
"city": "REYNOLDSBURG",
"state": "OH",
"postal_code": "430683589",
"telephone_number": "614-314-5416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 W BROADWAY ST",
"city": "NEW LEXINGTON",
"state": "OH",
"postal_code": "437641097",
"telephone_number": "740-343-4153"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NINA'S HEALTH CARE NEW LEX,INC",
"organizational_subpart": "NO",
"enumeration_date": "2019-01-22",
"last_updated": "2023-11-02",
"certification_date": "2023-11-02",
"status": "A",
"authorized_official_last_name": "FONGOD",
"authorized_official_first_name": "GRACE",
"authorized_official_title_or_position": "BOARD CHAIR",
"authorized_official_telephone_number": "614-314-5416"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Lexington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.