NPIMap

Organization Active NPI

Prime Home Health of Lee County, LLC

  • Home Health Agency
  • Opelika, AL
National Provider Identifier
1013457621
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PRIME HOME HEALTH OF LEE COUNTY, LLC
Practice address
2125 Executive Park Dr
Opelika, AL 36801-6041
Phone
(334) 745-7966
Fax
(334) 745-2153
NPI assigned
Mar 1, 2017
Last updated
Jun 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Authorized official

Name
Sandra Ledbetter
Title
Administrator
Phone
(334) 745-7966

Specialties & licenses 1

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

Addresses

Primary practice location

2125 Executive Park Dr
Opelika, AL 36801-6041

Mailing address

2125 Executive Park Dr
Opelika, AL 36801-6041
Phone (334) 745-7966

Other identifiers 1

IdentifierTypeStateIssuer
SOU714AMedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170508000621 AL Part A Provider - Home Health Agency 6204113921 Practice locations: Opelika, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013457621. Details of each certification follow.

Home health agency certification: CCN 017147

Legal name
PRIME HOME HEALTH OF LEE COUNTY, LLC
Doing business as
PRIME HOME HEALTH OF LEE COUNTY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 18, 1999
Last certification
Jun 25, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jan 6, 2017 in AL
Enrollment address
2125 Executive Park Drive
Opelika, AL 36801-6041

Care Compare: Home health agency

Medicare Care Compare
Listed as
Prime Home Health of Lee CountyCCN 017147 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Feb 18, 1999
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Physical therapy, Speech pathology

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
01D1004758Prime Home Health of Lee County LLC2125 Executive Park Dr, Opelika, AL 36801Certificate of waiverOct 3, 2026

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Archie J. Chapman Individual 5% Or Greater Direct Ownership Interest Mar 31, 2017 100%
Sandra Ledbetter Individual W-2 Managing EmployeeCeo Mar 31, 2017

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Home HealthTallassee, AL, CCN 017135 Home health agency 5% Or Greater Direct Ownership Interest (80%)
Limited Partnership Interest (80%)		 Sep 20, 2019
Sep 20, 2019
Community Hospice CareTallassee, AL, CCN 011583 Hospice 5% Or Greater Direct Ownership Interest (25%)
Operational/Managerial Control		 Jul 1, 2023
Jul 1, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • C & P Home Health, LLC

    dba Community Home Health

    • Home Health Agency
    • Tallassee, AL
    • NPI 1952958019

    5% Or Greater Direct Ownership Interest, Limited Partnership Interest

    CMS ownership
  • C & P Hospice, LLC

    dba Community Hospice Care

    • Community Based Hospice Care Agency
    • Tallassee, AL
    • NPI 1487714218

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Change-of-ownership history 1

DateEventCounterparty
Mar 31, 2017 Change of OwnershipThis provider was the buyer Southern Home HealthCCN 017147, AL, NPI 1124080643

Change of ownership 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591747200000",
    "number": "1013457621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 EXECUTIVE PARK DR",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368016041",
            "telephone_number": "334-745-7966",
            "fax_number": "334-745-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 EXECUTIVE PARK DR",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368016041",
            "telephone_number": "334-745-7966",
            "fax_number": "334-745-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HOME HEALTH OF LEE COUNTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "LEDBETTER",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-745-7966"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SOU714A",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Opelika, AL

Sources for this page

Verify at the official NPI Registry.