Active NPI
Promed Healthcare LLC
- Home Health Agency
- Parma, OH
National Provider Identifier
1922364140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- PROMED HEALTHCARE LLC
- Practice address
- 1416 W Pleasant Valley Rd
Parma, OH 44134-6720 - Phone
- (440) 842-3020
- Fax
- (440) 842-3023
- NPI assigned
- Apr 2, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Vitaliy Skrybka
- Title
- President
- Phone
- (216) 536-0957
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
1416 W Pleasant Valley Rd
Parma, OH 44134-6720
Mailing address
1416 W Pleasant Valley Rd
Parma, OH 44134-6720
Phone (440) 842-3020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120622000321 | OH | Part A Provider - Home Health Agency | 9739344862 | Practice locations: Parma, OH |
Home health agency certification: CCN 369000
- Legal name
- PROMED HEALTHCARE LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jun 1, 2013
- Last certification
- Jul 14, 2016
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Incorporated
- Mar 20, 2012 in OH
- Enrollment address
- 1416W Pleasant Valley Rd
Parma, OH 44134-6720
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Promed Healthcare LLC
- Ownership
- Proprietary
- Certified
- Jun 1, 2013
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider Directory- Tax ID family
- Promed Healthcare LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Parma, OH
- NPI 1508522129
Locations
1416 W Pleasant Valley Rd
Parma, OH 44134
Phone (440) 842-3020
Ownership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Vitaliy Skrybka | 5% Or Greater Direct Ownership Interest | Mar 20, 2012 | 50% |
| W-2 Managing Employee | Mar 20, 2012 | ||
| Olena Skrybka | 5% Or Greater Direct Ownership Interest | Mar 20, 2012 | 50% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333324800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1333324800000",
"number": "1922364140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1416 W PLEASANT VALLEY RD",
"city": "PARMA",
"state": "OH",
"postal_code": "441346720",
"telephone_number": "440-842-3020",
"fax_number": "440-842-3023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1416 W PLEASANT VALLEY RD",
"city": "PARMA",
"state": "OH",
"postal_code": "441346720",
"telephone_number": "440-842-3020",
"fax_number": "440-842-3023"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROMED HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-04-02",
"last_updated": "2012-04-02",
"status": "A",
"authorized_official_last_name": "SKRYBKA",
"authorized_official_first_name": "VITALIY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "216-536-0957",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parma, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.