NPIMap

Organization Active NPI

Monument Health Home Plus, LLC

Doing business as Monument Health Home Plus Home Health

  • Home Health Agency
  • Spearfish, SD
National Provider Identifier
1962952580
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MONUMENT HEALTH HOME PLUS, LLC
Doing business as
Monument Health Home Plus Home Health
Practice address
931 E Colorado Blvd
Spearfish, SD 57783-2783
Phone
(605) 644-4444
NPI assigned
Oct 6, 2016
Last updated
Jul 13, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MONUMENT HEALTH HOME PLUS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Authorized official

Name
Michael F Tilles
Title
VP Operations
Phone
(605) 519-1179

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

931 E Colorado Blvd
Spearfish, SD 57783-2783

Mailing address

PO Box 860013
Minneapolis, MN 55486-0013
Phone (605) 755-7649

Other practice location 1

1440 N Main St
Spearfish, SD 57783-1505
Phone (605) 644-4240

Other identifiers 1

IdentifierTypeStateIssuer
1962952580OtherSDHOME HEALTH

Other names 1

  • Monument Health Home Plus Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161130001837 SD Part A Provider - Home Health Agency 8729367776 Practice locations: Spearfish, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962952580. Details of each certification follow.

Home health agency certification: CCN 437037

Legal name
MONUMENT HEALTH HOME PLUS LLC
Doing business as
MONUMENT HEALTH HOME PLUS HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 5, 1992
Last certification
Aug 31, 2021
Ownership / control type
Proprietary
Organization structure
LLCNon-profit
Incorporated
Nov 1, 2016 in SD
Enrollment address
931 E Colorado Blvd
Spearfish, SD 57783-2783

Other NPIs with the same Medicare PAC ID 10

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Monument Health Home Plus Home HealthCCN 437037 · All quality measures
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Mar 5, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Regional Health Home Plus LLC11 organizations share this tax ID, including this one
Part of
Regional Health Home Plus LLC

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

931 E Colorado Blvd
Spearfish, SD 57783
Phone (605) 644-4240

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Ruta P Davidson Individual Operational/Managerial ControlPresident & Ceo Aug 18, 2018 100%
Monument Health Rapid City Hospital Inc Organization, Rapid City, SD Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2016 100%
Monument Health Inc Organization, Rapid City, SD Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2016 100%
Michael F Tilles Individual Corporate OfficerManager Sep 19, 2016
W-2 Managing EmployeePresident Sep 19, 2016

Owners & managing parties with NPI records 4

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

Facilities with the same owner 18

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

View all 18

Change-of-ownership history 1

DateEventCounterparty
Nov 1, 2016 Change of OwnershipThis provider was the buyer Spearfish Regional Hospital Home CareCCN 437037, SD, NPI 1740254028

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626134400000",
    "number": "1962952580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860013",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860013",
            "telephone_number": "605-755-7649",
            "fax_number": "605-755-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 E COLORADO BLVD",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577832783",
            "telephone_number": "605-644-4444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1440 N Main St",
            "address_purpose": "LOCATION",
            "city": "Spearfish",
            "state": "SD",
            "postal_code": "577831505",
            "country_code": "US",
            "telephone_number": "605-644-4240",
            "fax_number": "605-644-4241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MONUMENT HEALTH HOME PLUS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONUMENT HEALTH HOME PLUS, LLC",
        "enumeration_date": "2016-10-06",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A",
        "authorized_official_last_name": "TILLES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VP OPERATIONS",
        "authorized_official_telephone_number": "605-519-1179"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH",
            "identifier": "1962952580",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monument Health Home Plus Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Monument Health Home Plus Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spearfish, SD

Sources for this page

Verify at the official NPI Registry.