St. Mary'S Medical Center Home Health Services, LLC
Organization Active NPI Home Health Agency · Proctorville, OH
NPI 1013109560 · NPPES record last updated Feb 28, 2024
Key facts
- NPI
- 1013109560
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- ST. MARY'S MEDICAL CENTER HOME HEALTH SERVICES, LLC
- Practice address
- 520 State St
Proctorville, OH 45669-3014 - Phone
- (740) 886-7505
- Fax
- (740) 886-7074
- NPI assigned
- Aug 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Joshua L Proffitt
- Title
- President
- Phone
- (337) 233-1307
Owners & managing parties with NPI records 3
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Member of 1
Facilities with the same owner 15
Practitioners 3
-
Janie Carol Bradley, PTA
-
Kelli Rose Spurlock, FNP
Affiliated clinicians 36
-
Michael R Black, M.D.
-
Melissa Sue Callihan, APRN
-
Anna Marie Gibson, CFNP
-
Alicia Renee Johnson, P.A
-
Tamela R. King, C-FNP
-
Thomas Earl Moore, APRN, FNP-BC
-
Thuy Nguyen, DO
-
Cherri Lynn Sewell, APRN
-
Corey Danielle Webb, APRN
-
Nazia Ahmed, MD
-
Maegen Brennan, MSN, APRN, FNP-BC
-
Michael A Collins, D.O.
-
Tina Marie England, APRN
-
Timothy S Hart, MD
-
Todd Whitney Lester, PAC
-
Myron A Lewis, MD
Medicare Care Compare: Home health agency
- Listed as
- St Mary'S Home Health Service
- Overall star rating
- ★★★☆☆ 3 of 5
- Ownership
- Proprietary
- Certified
- Oct 9, 2009
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D1080506 | St Mary'S Medical Center Home Health | Certificate of waiver | Feb 24, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
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
- LLC · Proprietary
- Incorporated
- Aug 14, 2007 in WV
- Enrollment address
- 520 State St
Proctorville, OH 45669-3014
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Unitedhealth Group Incorporated |
5% Or Greater Indirect Ownership Interest | Feb 22, 2023 | 67% |
| Marcus Donavon Macip |
Corporate Officer |
Feb 22, 2023 | |
| Heather Miller |
W-2 Managing Employee |
Mar 8, 2025 | |
| Kimberly Seymour |
Corporate Officer |
Feb 22, 2023 | |
| West Virginia Health Care Group, LLC |
5% Or Greater Direct Ownership Interest | Feb 11, 2008 | 67% |
| Wendy S Daigle |
Corporate Director |
Oct 1, 2022 | |
| LHC Group Inc |
5% Or Greater Indirect Ownership Interest | Oct 9, 2009 | 67% |
| Operational/Managerial Control | Feb 11, 2008 | ||
| St Marys Medical Center, Inc |
5% Or Greater Direct Ownership Interest | Feb 11, 2008 | 33% |
| Joshua Lee Proffitt |
Corporate Officer |
Aug 1, 2012 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080306000204 | OH | Part a Provider - Home Health Agency | 4688760085 | Practice locations: Proctorville, OH |
National Provider Directory
- Tax ID family
- St Mary'S Home Health Service
Locations
168 County Road 775
#B
Proctorville, OH 45669
Phone (704) 886-7505
305 State St
Proctorville, OH 45669
Phone (704) 886-7505
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
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
- St. Mary's Home Health Service
Other providers in Proctorville, OH
- Christina R. Senior
- Thomas R Shay Jr.
- Beverly Spears
- Taylor James Spears
- St. Mary'S Home Health
- Kimberly S. Starks
- Mary Steele
- Rachel Stevens
- Sara Beth Stewart
- Chad Stockham
All providers in Proctorville, OH · Home Health Agency in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.