NPIMap

Organization Active NPI

Audubon Home Health Inc

  • Home Health Agency
  • Baton Rouge, LA
National Provider Identifier
1861459398
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
978 Issued in LA
Legal business name
AUDUBON HOME HEALTH INC
Practice address
9256 Interline Ave
Baton Rouge, LA 70809-1907
Phone
(225) 218-8009
Fax
(225) 218-0809
NPI assigned
Apr 27, 2006
Last updated
Dec 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Authorized official

Name
Mr. Ray W Banker Jr., RN
Title
Owner
Phone
(225) 218-8009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 978 LA Primary

Addresses

Primary practice location

9256 Interline Ave
Baton Rouge, LA 70809-1907

Mailing address

9256 Interline Ave
Baton Rouge, LA 70809-1907
Phone (225) 218-8009

Other identifiers 1

IdentifierTypeStateIssuer
1400491MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080904000003 LA Part B Supplier - Independent Clinical Laboratory 1254407968 Practice locations: Baton Rouge, LA
O20100224000574 LA Part A Provider - Home Health Agency 1254407968 Practice locations: Baton Rouge, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861459398. Details of each certification follow.

Home health agency certification: CCN 197771

Legal name
AUDUBON HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 16, 2001
Last certification
Aug 27, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Aug 24, 2001 in LA
Enrollment address
9256 Interline Ave
Baton Rouge, LA 70809-1907

Care Compare: Home health agency

Medicare Care Compare
Listed as
Audubon Home HealthCCN 197771 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Oct 16, 2001
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
19D0991187Audubon Home Health, Inc9256 Interline Ave, Baton Rouge, LA 70809Certificate of waiverSep 12, 2027

National Provider Directory

National Provider Directory

Locations

9256 Interline Ave
Baton Rouge, LA 70809
Phone (225) 218-8009

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Raymond W Banker Individual 5% Or Greater Direct Ownership Interest Jun 12, 2007 100%
Corporate DirectorOwner/Administrator Jun 12, 2007 100%
W-2 Managing EmployeeOwner/Administrator Jun 12, 2007 100%
Carol Cappiello Individual Operational/Managerial ControlDirector of Nursing Apr 1, 2022 100%
Linda Dianne Troxclair Individual Corporate Officer Jan 1, 2012
Operational/Managerial Control Feb 10, 2010 100%

Practitioners & affiliated clinicians

Affiliated clinicians 85

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

View all 85

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640649600000",
    "number": "1861459398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9256 INTERLINE AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708091907",
            "telephone_number": "225-218-8009",
            "fax_number": "225-218-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9256 INTERLINE AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708091907",
            "telephone_number": "225-218-8009",
            "fax_number": "225-218-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUDUBON HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A",
        "authorized_official_last_name": "BANKER",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-218-8009",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "LA",
            "license": "978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1400491",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.