Avid Healthcare, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

AVID HEALTHCARE, LLC

Practice address

1557 Vernon Odom Blvd Ste 104
Akron, OH 44320-4061

Phone

(330) 818-2979

Fax

(234) 525-5825

NPI assigned

Mar 23, 2011

Organization subpart

No

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

Authorized official

Name

L Michael Parker

Title

Ceo

Phone

(330) 818-2979

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Home health agency certification: CCN 369368

Legal name

AVID HEALTHCARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 19, 2023

Last certification

May 10, 2023

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Nov 28, 2017 in OH

Enrollment address

1557 Vernon Odom Blvd
Ste 104
Akron, OH 44320-4061
HHA Branch

Listed as

Avid Healthcare LLCCCN 369368

Ownership

Proprietary

Certified

May 19, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Occupational therapy

Locations

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.

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724976000000",
    "number": "1881993301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 SPRINGSIDE DRIVE",
            "address_2": "STE 209",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443334516",
            "telephone_number": "330-818-2979",
            "fax_number": "234-525-5825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1557 VERNON ODOM BLVD STE 104",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443204061",
            "telephone_number": "330-818-2979",
            "fax_number": "234-525-5825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "351 Thornton Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Lithia Springs",
            "state": "GA",
            "postal_code": "301221589",
            "country_code": "US",
            "telephone_number": "330-356-4219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AVID HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-23",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "L MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-818-2979"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0203389",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0057199",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3113115",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Devin Avery
• Edward B Avery Jr.
• Kim Denise Avery
• Ross Avery
• Ryan A Avery, CDCA
• Nadim M Awad
• Ali Mohamed Awada
• Hussein Awada
• Herbert Scott Awender, MD
• Nancy Elaine Awender, M.D.

• All providers in Akron, OH
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.

Verify at the official NPI Registry.