Organization Active NPI

Ambassador Home Health Services, LLC

  • Home Health Agency
  • Reynoldsburg, OH
National Provider Identifier
1972521664
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
AMBASSADOR HOME HEALTH SERVICES, LLC
Practice address
7449 E Main St
Reynoldsburg, OH 43068-1205
Phone
(614) 577-1950
Fax
(614) 577-1956
NPI assigned
Jul 18, 2006
Last updated
Apr 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
Tara Lynn Linton
Title
Financial Manager
Phone
(614) 577-1950

Specialties & licenses 1

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

Addresses

Primary practice location

7449 E Main St
Reynoldsburg, OH 43068-1205

Mailing address

7449 E Main St
Reynoldsburg, OH 43068-1205
Phone (614) 577-1950

Other identifiers 1

IdentifierTypeStateIssuer
2778696MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061130000060 OH Part A Provider - Home Health Agency 4688672660 Practice locations: Reynoldsburg, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972521664. Details of each certification follow.

Home health agency certification: CCN 368201

Legal name
AMBASSADOR HOME HEALTH SERVICES, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 26, 2007
Last certification
Aug 9, 2017
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
6434 E Main St
Ste 205
Reynoldsburg, OH 43068-2574

Care Compare: Home health agency

Medicare Care Compare
Listed as
Ambassador Home Health ServicesCCN 368201 · All quality measures
Ownership
Proprietary
Certified
Sep 26, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1063480Ambassador Home Health7449 E Main St, Reynoldsburg, OH 43068Certificate of waiverJan 15, 2027

National Provider Directory

National Provider Directory

Locations

2300 S Hamilton Rd
Columbus, OH 43232
Phone (614) 577-1950

111 S Broad St
Ste 109
Lancaster, OH 43130
Phone (614) 577-1950

6434 E Main St
Ste 205
Reynoldsburg, OH 43068
Phone (614) 577-1950

7449 E Main St
Reynoldsburg, OH 43068
Phone (614) 577-1950

Ownership & related parties

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.

NameRoleSinceShare
Gagan Bastola Individual 5% Or Greater Indirect Ownership Interest Nov 25, 2024 10%
Limited Partnership Interest Nov 25, 2024 10%
Corporate Director Nov 25, 2024 10%
Yam Mishra Individual 5% Or Greater Indirect Ownership Interest Nov 25, 2024 20%
Limited Partnership Interest Nov 25, 2024 20%
Corporate Director Nov 25, 2024 20%
W-2 Managing Employee Nov 25, 2024 20%
Balaram Katel Individual 5% Or Greater Indirect Ownership Interest Nov 25, 2024 10%
Limited Partnership Interest Nov 25, 2024 10%
Corporate Director Nov 25, 2024 10%
Radhika Acharya Individual 5% Or Greater Direct Ownership Interest Nov 25, 2024 40%
Limited Partnership Interest Nov 25, 2024 40%
Corporate Officer Nov 25, 2024 40%
Jagat Acharya Individual 5% Or Greater Indirect Ownership Interest Nov 25, 2024 20%
Limited Partnership Interest Nov 25, 2024 20%
Corporate Director Nov 25, 2024 20%

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1972521664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7449 E MAIN ST",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430681205",
            "telephone_number": "614-577-1950",
            "fax_number": "614-577-1956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7449 E MAIN ST",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430681205",
            "telephone_number": "614-577-1950",
            "fax_number": "614-577-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBASSADOR HOME HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "LINTON",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "FINANCIAL MANAGER",
        "authorized_official_telephone_number": "614-577-1950"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2778696",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reynoldsburg, OH

Sources for this page

Verify at the official NPI Registry.