Active NPI
Family Home Medical Hospice LLC
- Community Based Hospice Care Agency
- Mount Carmel, PA
National Provider Identifier
1972813301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- FAMILY HOME MEDICAL HOSPICE LLC
- Practice address
- 50 S Oak St
Mount Carmel, PA 17851-2156 - Phone
- (570) 339-4083
- NPI assigned
- Oct 19, 2010
- 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. Debra Elaine Petras
- Title
- Chief Executive Officer
- Phone
- (740) 632-1406
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | PA | Primary |
Addresses
Primary practice location
50 S Oak St
Mount Carmel, PA 17851-2156
Mailing address
2070 W 106TH St
Carmel, IN 46032-7918
Phone (317) 652-1584
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110712000542 | PA | Part A Provider - Hospice | 0840468161 | Practice locations: Mount Carmel, PA |
Hospice certification: CCN 391739
- Legal name
- FAMILY HOME MEDICAL HOSPICE LLC
- Doing business as
- 1ST CARE PALLIATIVE AND HOSPICE SERVICES
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Sep 16, 2011
- Last certification
- Apr 2, 2021
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC
- Incorporated
- Oct 11, 2010 in PA
- Enrollment address
- 50 S Oak St
Mount Carmel, PA 17851-2156
Care Compare: Hospice
Medicare Care Compare- Listed as
- 1St Care Palliative and Hospice Services
- Ownership
- For-Profit
- Certified
- Sep 16, 2011
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D0876943 | Family Home Medical | Certificate of waiver | Sep 26, 2027 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| SRS Healthcare Holding, LLC | 5% Or Greater Indirect Ownership Interest | Jun 6, 2025 | 100% |
| Hari Shanthan Nagi Reddy | 5% Or Greater Indirect Ownership Interest | Jun 6, 2025 | 100% |
| Corporate Officer | Jun 6, 2025 | 100% | |
| Jane Evans | W-2 Managing Employee | Jun 6, 2025 | |
| Connections Life Care of Pennsylvania, LLC | 5% Or Greater Direct Ownership Interest | Dec 12, 2022 | 100% |
| Brandon M Roscoe | W-2 Managing Employee | Nov 1, 2023 |
Owners & managing parties with NPI records 1
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.
-
- Nurse Practitioner
- Mount Carmel, PA
- NPI 1316869217
-
- Physical Therapist
- Fortville, IN
- NPI 1285851899
Affiliated clinicians 5
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": "1287446400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1767830400000",
"number": "1972813301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2070 W 106TH ST",
"city": "CARMEL",
"state": "IN",
"postal_code": "460327918",
"telephone_number": "317-652-1584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 S OAK ST",
"city": "MOUNT CARMEL",
"state": "PA",
"postal_code": "178512156",
"telephone_number": "570-339-4083"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY HOME MEDICAL HOSPICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-10-19",
"last_updated": "2026-01-08",
"certification_date": "2026-01-08",
"status": "A",
"authorized_official_last_name": "PETRAS",
"authorized_official_first_name": "DEBRA",
"authorized_official_middle_name": "ELAINE",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "740-632-1406",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "PA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Carmel, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.