Boschulte's Pride II LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

BOSCHULTE'S PRIDE II LLC

Practice address

2242 S Hamilton Rd Ste 201
Columbus, OH 43232-4300

Phone

(614) 751-6308

Fax

(614) 751-6342

NPI assigned

Oct 3, 2008

Last updated

Mar 14, 2017By 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. Mary L Boschulte

Title

Administrator/Director of Nursing

Phone

(614) 751-6308

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 1912158304. Details of each certification follow.

• CCN 368282 Home health agency · Active · Details

Home health agency certification: CCN 368282

Legal name

BOSCHULTE'S PRIDE II LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 12, 2009

Last certification

Jan 28, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Enrollment address

2242 S Hamilton Rd
Ste 201
Columbus, OH 43232-4300

Listed as

Boschulte's Pride II LLCCCN 368282 · All quality measures

Ownership

Proprietary

Certified

Nov 12, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, 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

Locations

All disclosed owners & managing parties 2

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": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1912158304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2242 S HAMILTON RD STE 201",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432324300",
            "telephone_number": "614-751-6308",
            "fax_number": "614-751-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2242 S HAMILTON RD STE 201",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432324300",
            "telephone_number": "614-751-6308",
            "fax_number": "614-751-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSCHULTE'S PRIDE II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "BOSCHULTE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR/DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "614-751-6308",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3073847",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Borsukevich
• Eric D. Bortmas, MS, ATC, CSCS
• Zachary Borzotta
• Melissa Bosart, LSW
• Mary Lee Boschulte, CRNP
• Jeffrey Ryan Bose, DNP
• Vanessa Bose, PMHNP
• Tiashieka Lamea Boseman, LISW
• Heather Kaye Bosley, CDCA
• Kenyatta R Bosley

• Home Health Agency in Columbus, OH
• Providers in Columbus, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.