NPIMap

Organization Active NPI

St. Mary's Medical Center Home Health Services, LLC

Doing business as St. Mary's Home Health Service

  • Home Health Agency
  • Proctorville, OH
National Provider Identifier
1013109560
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ST. MARY'S MEDICAL CENTER HOME HEALTH SERVICES, LLC
Doing business as
St. Mary's Home Health Service
Practice address
520 State St
Proctorville, OH 45669-3014
Phone
(740) 886-7505
Fax
(740) 886-7074
NPI assigned
Aug 17, 2007
Last updated
Feb 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Authorized official

Name
Joshua L Proffitt
Title
President
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

520 State St
Proctorville, OH 45669-3014

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other names 1

  • St. Mary's Home Health Service Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080306000204 OH Part A Provider - Home Health Agency 4688760085 Practice locations: Proctorville, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013109560. Details of each certification follow.

Home health agency certification: CCN 368269

Legal name
ST. MARY'S MEDICAL CENTER HOME HEALTH SERVICES, LLC
Doing business as
ST. MARYS HOME HEALTH SERVICE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 9, 2009
Last certification
May 24, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Aug 14, 2007 in WV
Enrollment address
520 State St
Proctorville, OH 45669-3014

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
St Mary's Home Health ServiceCCN 368269 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Oct 9, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, 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
36D1080506St Mary's Medical Center Home Health520 State Street, Proctorville, OH 45669Certificate of waiverFeb 24, 2028

National Provider Directory

National Provider Directory
Tax ID family
St Mary's Home Health Service2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

168 County Road 775
#B
Proctorville, OH 45669
Phone (704) 886-7505

305 State St
Proctorville, OH 45669
Phone (704) 886-7505

3246 US Route 60
Ste 13
Huntington, WV 25705
Phone (304) 733-5010

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 67%
Marcus Donavon Macip Individual Corporate OfficerSecretary Feb 22, 2023
Heather Miller Individual W-2 Managing EmployeeAd; Mar 8, 2025
Kimberly Seymour Individual Corporate OfficerCfo/Treasurer Feb 22, 2023
West Virginia Health Care Group, LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Feb 11, 2008 67%
Wendy S Daigle Individual Corporate DirectorDirector of Licensure & Regulatory Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Oct 9, 2009 67%
Operational/Managerial Control Feb 11, 2008
St Marys Medical Center, Inc Organization, Huntington, WV Corporation 5% Or Greater Direct Ownership Interest Feb 11, 2008 33%
Joshua Lee Proffitt Individual Corporate OfficerPresident Aug 1, 2012

Owners & managing parties with NPI records 3

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

Facilities with the same owner 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 3

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.

Affiliated clinicians 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1013109560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-233-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 STATE ST",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456693014",
            "telephone_number": "740-886-7505",
            "fax_number": "740-886-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S MEDICAL CENTER HOME HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-17",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Mary's Home Health Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Mary's Home Health Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Proctorville, OH

Sources for this page

Verify at the official NPI Registry.