Gentle Shepherd Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

7763 Issued in OK

Legal business name

GENTLE SHEPHERD HOME HEALTH, INC.

Practice address

2216 Shadowlake Dr
Oklahoma City, OK 73159-7440

Phone

(405) 691-8600

Fax

(405) 691-8601

NPI assigned

May 3, 2006

Last updated

Jan 7, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Elerick

Title

Owner

Phone

(405) 691-8600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033177514. Details of each certification follow.

• CCN 377665 Home health agency · Active · Details

Home health agency certification: CCN 377665

Legal name

GENTLE SHEPHERD HOME HEALTH, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 19, 2004

Last certification

Feb 11, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Sep 17, 2003 in OK

Enrollment address

2216 Shadowlake Dr
Oklahoma City, OK 73159-7645

Listed as

Gentle Shepherd Home Health, IncorporatedCCN 377665 · All quality measures

Ownership

Proprietary

Certified

Feb 19, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

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

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1033177514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 SHADOWLAKE DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597440",
            "telephone_number": "405-691-8600",
            "fax_number": "405-691-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 SHADOWLAKE DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597440",
            "telephone_number": "405-691-8600",
            "fax_number": "405-691-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENTLE SHEPHERD HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "ELERICK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-691-8600"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OK",
            "license": "7763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200055890A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.

Verify at the official NPI Registry.