NPIMap

Organization Active NPI

Vernon Investment Group, LLC

Doing business as Vernon Home Health

  • Home Health Agency
  • Leesville, LA
National Provider Identifier
1902005077
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1088 Issued in LA
Legal business name
VERNON INVESTMENT GROUP, LLC
Doing business as
Vernon Home Health
Practice address
213 Alexandria Hwy
Leesville, LA 71446-2147
Phone
(337) 238-0506
Fax
(337) 238-1528
NPI assigned
Jul 17, 2007
Last updated
Sep 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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

Authorized official

Name
Dr. Hanna Lubbos, M.D.NPI 1447262639
Title
Member
Phone
(337) 239-7227

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1088 LA Primary

Addresses

Primary practice location

213 Alexandria Hwy
Leesville, LA 71446-2147

Mailing address

PO Box 1550
Leesville, LA 71496-1550
Phone (337) 238-0506

Other identifiers 4

IdentifierTypeStateIssuer
19D0716607OtherCLIA
07 9806031OtherLAOCCUPATION LICENSE
19-7413OtherMEDICARE
401OtherLADHH

Other names 1

  • Vernon Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080618000715 LA Part A Provider - Home Health Agency 8527139500 Practice locations: Leesville, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902005077. Details of each certification follow.

Home health agency certification: CCN 197413

Legal name
VERNON INVESTMENT GROUP, LLC
Doing business as
VERNON HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 12, 1991
Last certification
Oct 14, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Apr 23, 2007 in LA
Enrollment address
213 Alexandria Hwy
Leesville, LA 71446-2147

Care Compare: Home health agency

Medicare Care Compare
Listed as
Vernon Home HealthCCN 197413 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Jul 12, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Occupational therapy

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Guru P Ghanta Individual 5% Or Greater Direct Ownership Interest Oct 1, 2007 11.5%
Operational/Managerial ControlManager/Authorized Official Mar 28, 2012
Jose Mathew Individual 5% Or Greater Direct Ownership Interest Oct 1, 2007 11.5%
Raymond Meadaa Individual 5% Or Greater Direct Ownership Interest Oct 1, 2007 11.5%
Operational/Managerial ControlManager Oct 1, 2007 12%
Other Jul 16, 2014 11.5%
Melissa K Moss Individual 5% Or Greater Direct Ownership Interest Oct 1, 2010 5%
Kanchan P. Upadhyay Individual 5% Or Greater Direct Ownership Interest Oct 1, 2007 11.5%
Operational/Managerial ControlManager Mar 1, 2012
Francis Alouysious Fraser Individual 5% Or Greater Direct Ownership Interest Dec 31, 2011 5%
Jocelyne a Saikali Individual 5% Or Greater Direct Ownership Interest Oct 1, 2007 11.5%
Hussein a Alammar Individual Contracted Managing EmployeeMember Mar 1, 2012 12%
5% Or Greater Direct Ownership Interest Oct 1, 2007 11.5%
Mohammad M Saidan Individual 5% Or Greater Direct Ownership Interest Jan 1, 2013 7%
Shawn P Granger Individual 5% Or Greater Direct Ownership Interest Oct 1, 2010 5%
Khaled Ghorab Individual 5% Or Greater Direct Ownership Interest Oct 1, 2010 5%
Vernon Investment Group, LLC Organization, Leesville, LA Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Oct 1, 2007 100%

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 10

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

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1902005077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1550",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714961550",
            "telephone_number": "337-238-0506",
            "fax_number": "337-238-1528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 ALEXANDRIA HWY",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714462147",
            "telephone_number": "337-238-0506",
            "fax_number": "337-238-1528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNON INVESTMENT GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "LUBBOS",
        "authorized_official_first_name": "HANNA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "337-239-7227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "LA",
            "license": "1088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "19D0716607",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATION LICENSE",
            "identifier": "07 9806031",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "19-7413",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHH",
            "identifier": "401",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vernon Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesville, LA

Sources for this page

Verify at the official NPI Registry.