NPIMap

Organization Active NPI

Pediatric Services of America, LLC

Doing business as Aveanna Healthcare

  • Nursing Care Agency
  • Tinley Park, IL
National Provider Identifier
1891740601
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
1008101 Issued in IL
Legal business name
PEDIATRIC SERVICES OF AMERICA, LLC
Doing business as
Aveanna Healthcare
Practice address
18440 Thompson CT
Suite 108
Tinley Park, IL 60477-5426
Phone
(707) 429-5551
Fax
(708) 444-1278
NPI assigned
May 23, 2006
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Matthew Buckhalter
Title
Cfo
Phone
(470) 464-8000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Nursing Care Agency 251J00000X 1008101 IL Primary

Addresses

Primary practice location

18440 Thompson CT
Suite 108
Tinley Park, IL 60477-5426

Mailing address

400 Interstate North Pkwy SE Ste 1600
Atlanta, GA 30339-5047
Phone (470) 464-8000

Other names 1

  • Aveanna Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080827000523 IL Part A Provider - Home Health Agency 5991614760 1 other NPI on this enrollment
Practice locations: Schaumburg, IL; Tinley Park, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891740601. Details of each certification follow.

Home health agency certification: CCN 147600

Legal name
PEDIATRIC SERVICES OF AMERICA, LLC
Doing business as
AVEANNA HEALTHCARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 10, 1995
Last certification
May 21, 2009
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Dec 28, 2020 in GA
Enrollment address
18440 Thompson CT
Ste 108
Tinley Park, IL 60477-5427

Other NPIs with the same Medicare PAC ID 19

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

View all 19

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Aveanna HealthcareCCN 147600 · All quality measures
Ownership
Proprietary
Certified
Feb 10, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Services of76 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 3

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations (25 of 26)

12100 E Iliff Ave
Ste A250
Aurora, CO 80014
Phone (303) 363-4107

1000 Bridgeport Ave
Ste 309
Shelton, CT 06484
Phone (203) 381-1530

126 Integra Breeze Ln
Ste 3B
Daytona Beach, FL 32117
Phone (386) 304-0702

42 Barkley Cir
Ste 3
Fort Myers, FL 33907
Phone (239) 939-3159

760 North Dr
Ste D
Melbourne, FL 32934
Phone (321) 254-4254

803 Jenks Ave
Ste 24A
Panama City, FL 32401
Phone (850) 387-7685

2114 Airport Blvd
Ste 2000
Pensacola, FL 32504
Phone (850) 444-4365

1645 Palm Beach Lakes Blvd
Ste 300
West Palm Beach, FL 33401
Phone (561) 683-7851

81 Peeples Valley Rd SE
Ste 103
Cartersville, GA 30121
Phone (770) 383-4629

6075 The Corners Pkwy
Ste 120
Peachtree Corners, GA 30092
Phone (770) 263-6373

23 Chatham Ctr S
#B
Savannah, GA 31405
Phone (912) 447-5437

225 Country Club Dr
Ste 240
Stockbridge, GA 30281
Phone (770) 810-6922

9270 Siegen Ln
Bldg 903
Baton Rouge, LA 70810

116 Long Pond Rd
Ste 9
Plymouth, MA 02360
Phone (508) 591-4113

4530 Park Rd
Ste 105
Charlotte, NC 28209
Phone (704) 335-9797

220A N McPherson Church Rd
Fayetteville, NC 28303

1025 W H Smith Blvd
Ste 100
Greenville, NC 27834
Phone (252) 756-7233

1551 Westbrook Plaza Dr
Ste 110
Winston Salem, NC 27103

1400 N Providence Rd
Ste 300
Media, PA 19063
Phone (215) 887-4009

1501 Reedsdale St
Ste 4002
Pittsburgh, PA 15233
Phone (412) 322-4140

5 Hearthstone Ct
Ste 203
Reading, PA 19606
Phone (610) 779-6435

1544 E 3rd St
Williamsport, PA 17701
Phone (570) 323-1690

114 Commons Blvd
#C
Piedmont, SC 29673
Phone (864) 295-8655

6330 N Center Dr
Ste 142
Norfolk, VA 23502
Phone (757) 461-6310

7602 Bridgeport Way W
Ste 2B
Lakewood, WA 98499
Phone (253) 912-4860

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
J.H. Whitney VII LP Organization, New Canaan, CT For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 6.18%
Kathleen Flynn Individual W-2 Managing EmployeeAd; May 4, 2012
Psa Healthcare Investment Holding LLC Organization, New Canaan, CT LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 7.14%
Aveanna Healthcare LLC Organization, Atlanta, GA Created for acquisition, LLC, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 100%
Aveanna Healthcare Intermediate Holdings LLC Organization, Atlanta, GA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 100%
Pediatric Services Holding LLC Organization, Atlanta, GA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 31, 2007 100%
Aveanna Healthcare Holdings Inc Organization, Atlanta, GA Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 100%
Nut Tree Master Fund LP Organization, New York, NY For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 31, 2023 5.69%
Matthew Buckhalter Individual Corporate OfficerCfo Jul 7, 2023
Corporate DirectorCfo Jul 7, 2023
Hamilton Lane Co-Investment Fund III Holdings - 2 LP Organization, Bala Cynwyd, PA For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 6.68%
Deborah Stewart Individual Corporate DirectorDirector Jul 7, 2023
Bain Capital Fund XI LP Organization, Boston, MA For-profit, Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 16, 2017 31.87%
Psa Healthcare Intermediate Holding LLC Organization, Atlanta, GA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 19, 2015 100%
Jerrold Perchik Individual Corporate OfficerSecretary Apr 29, 2024
Pediatric Services of America LLC Organization, Atlanta, GA LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 31, 2007 100%
Bcpe Eagle Investor, L.P. Organization, Boston, MA Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 29, 2021 37.52%
Jeffrey Shaner Individual Corporate OfficerCeo Dec 1, 2015
Corporate DirectorCeo Jan 1, 2023

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Aveanna HealthcareEnglewood, CO, CCN 067192 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Sep 17, 2016
Thrive Skilled Pediatric CareScottsdale, AZ, CCN 037286 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Jun 2, 2025
Aveanna HealthcareErie, PA, CCN 397310 Home health agency 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2016
Aveanna HealthcareLoveland, CO, CCN 067477 Home health agency 5% Or Greater Direct Ownership Interest (100%) Sep 26, 2020
Aveanna HealthcareWexford, PA, CCN 397278 Home health agency 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2016
Aveanna HealthcareWestminster, CO, CCN 067496 Home health agency 5% Or Greater Direct Ownership Interest (100%) Sep 26, 2020
Aveanna HealthcareDu Bois, PA, CCN 398190 Home health agency 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2016

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 122

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

  • 5 Star Home Health Services, LLC

    dba Aveanna Home Health

    • Home Health Agency
    • Orlando, FL
    • NPI 1376584730

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Psa Healthcare Inv

    CMS ownership
  • 5 Star Home Health Services, LLC

    dba Aveanna Home Health

    • Home Health Agency
    • Gainesville, FL
    • NPI 1518182773

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Nut Tree Master Fu

    CMS ownership
  • Andventure, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Chambersburg, PA
    • NPI 1013150275

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Nut Tree Master Fu

    CMS ownership
  • Andventure, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Phoenix, AZ
    • NPI 1013156470

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Nut Tree Master Fu

    CMS ownership
  • Andventure, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Lancaster, PA
    • NPI 1093788002

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Nut Tree Master Fu

    CMS ownership
  • Andventure, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • State College, PA
    • NPI 1760621122

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Nut Tree Master Fu

    CMS ownership
  • Andventure, LLC

    dba Aveanna Healthcare

    • Home Health Agency
    • Springfield, MA
    • NPI 1881833259

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Nut Tree Master Fu

    CMS ownership
  • Angel's Touch Home Care, LLC

    dba Aveanna Home Health

    • Home Health Agency
    • West Pittston, PA
    • NPI 1376762237

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Nut Tree Master Fu

    CMS ownership
  • Care Unlimited Inc

    dba Aveanna Healthcare

    • Home Health Agency
    • Du Bois, PA
    • NPI 1811279540

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Nut Tree Master Fu

    CMS ownership
  • Care Unlimited Inc.

    dba Aveanna Healthcare

    • Home Health Agency
    • Wexford, PA
    • NPI 1407809114

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Nut Tree Master Fu

    CMS ownership
  • Care Unlimited Inc.

    dba Aveanna Healthcare

    • Home Health Agency
    • Erie, PA
    • NPI 1912101726

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Nut Tree Master Fu

    CMS ownership
  • Comfort Care Coastal Home Health, LLC

    dba Aveanna Home Health

    • Home Health Agency
    • Foley, AL
    • NPI 1740653047

    Aveanna Healthcare Holdings Inc, Aveanna Healthcare Intermediate Holdings LLC, Aveanna Healthcare LLC, Bain Capital Fund XI LP, Bcpe Eagle Investor, L.P., Hamilton Lane Co-Investment Fund III Holdings - 2 LP, J.H. Whitney VII LP, Nut Tree Master Fu

    CMS ownership
View all 122

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1891740601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERSTATE NORTH PKWY SE STE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395047",
            "telephone_number": "470-464-8000",
            "fax_number": "770-248-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18440 THOMPSON CT",
            "address_2": "SUITE 108",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604775426",
            "telephone_number": "707-429-5551",
            "fax_number": "708-444-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SERVICES OF AMERICA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "BUCKHALTER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "470-464-8000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "IL",
            "license": "1008101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tinley Park, IL

Sources for this page

Verify at the official NPI Registry.