NPIMap

Organization Active NPI

Basin Home Health Inc.

  • Home Health Agency
  • Farmington, NM
National Provider Identifier
1013910348
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
BASIN HOME HEALTH INC.
Practice address
200 N Orchard Ave
Farmington, NM 87401-6225
Phone
(505) 325-8231
Fax
(505) 325-4516
NPI assigned
May 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Authorized official

Name
Mary Nelson
Title
Controller
Phone
(505) 325-8231

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NM Primary
Community Based Hospice Care Agency 251G00000X NM

Addresses

Primary practice location

200 N Orchard Ave
Farmington, NM 87401-6225

Mailing address

200 N Orchard Ave
Farmington, NM 87401-6225
Phone (505) 325-8231

Other identifiers 1

IdentifierTypeStateIssuer
N2145MedicaidNM

Other names 1

  • Basin Home Health & Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120412000781 NM Part A Provider - Hospice 5294644241 Practice locations: Farmington, NM
O20120426000647 NM Part A Provider - Home Health Agency 5294644241 Practice locations: Farmington, NM

Hospice certification: CCN 321548

Legal name
BASIN HOME HEALTH INC.
Doing business as
BASIN HOME HEALTH AND HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 17, 2003
Last certification
Aug 17, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Sep 23, 1992 in NM
Enrollment address
200 N Orchard Ave
Farmington, NM 87401-6225

Home health agency certification: CCN 327104

Legal name
BASIN HOME HEALTH INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 23, 1993
Last certification
Jan 22, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Enrollment address
200 N Orchard Ave
Farmington, NM 87401-6225

Care Compare: Home health agency

Medicare Care Compare
Listed as
Basin Home Health IncCCN 327104
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Feb 23, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Occupational therapy

Care Compare: Hospice

Medicare Care Compare
Listed as
Basin Home Health & HospiceCCN 321548
Ownership
For-Profit
Certified
Sep 17, 2003
Medicare certification status
ActiveFrom the Provider of Services file

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
32D0869328Basin Home Health Inc200 North Orchard Avenue, Farmington, NM 87401Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

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
Brett Gladden Individual W-2 Managing Employee May 1, 2018 100%
Melvin V Moffitt Individual 5% Or Greater Direct Ownership InterestCeo, Board President Jul 1, 2017 100%
Corporate OfficerCeo, Board President Jul 1, 2017 100%
Corporate DirectorCeo, Board President Jul 1, 2017 100%
W-2 Managing EmployeeCeo, Board President Jul 1, 2017 100%
Travis Donalson Individual Corporate Director Jan 1, 2016 100%
W-2 Managing Employee Jan 1, 2016 100%
Gary Moffitt Individual Corporate Officer Jul 1, 2017 100%
Mary Meiers Nelson Individual Corporate OfficerCoo Jan 1, 2020 100%

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203638400000",
    "number": "1013910348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N ORCHARD AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016225",
            "telephone_number": "505-325-8231",
            "fax_number": "505-325-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N ORCHARD AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016225",
            "telephone_number": "505-325-8231",
            "fax_number": "505-325-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASIN HOME HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2008-02-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "505-325-8231"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NM",
            "license": null,
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NM",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N2145",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Basin Home Health & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.