Advantage Skilled Care, L.L.C.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

52643260 Issued in OH

Legal business name

ADVANTAGE SKILLED CARE, L.L.C.

Practice address

4292 Old Scioto TRL
Portsmouth, OH 45662-6641

Phone

(740) 354-5671

Fax

(740) 354-4432

NPI assigned

Aug 2, 2005

Last updated

Aug 9, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael S Vallee

Title

President/Administrator

Phone

(740) 354-5671

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891796850. Details of each certification follow.

• CCN 368059 Home health agency · Active · Details

Home health agency certification: CCN 368059

Legal name

ADVANTAGE SKILLED CARE, LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 2, 2004

Last certification

Oct 25, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Sep 28, 2003 in OH

Enrollment address

4292 Old Scioto Trail
Portsmouth, OH 45662-6641

Listed as

Advantage Skilled Care, LLCCCN 368059 · All quality measures

Ownership

Proprietary

Certified

Jul 2, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 5

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": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1891796850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1656 COLES BLVD",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622632",
            "telephone_number": "740-354-5671",
            "fax_number": "740-354-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4292 OLD SCIOTO TRL",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456626641",
            "telephone_number": "740-354-5671",
            "fax_number": "740-354-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE SKILLED CARE, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "VALLEE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "740-354-5671",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "52643260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2567931",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.