Premier Golden Heart Health Care Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

010291 Issued in TX

Legal business name

PREMIER GOLDEN HEART HEALTH CARE SERVICES LLC

Practice address

2412 Old North Rd Ste 101K
Denton, TX 76209-1524

Phone

(940) 566-4999

Fax

(940) 566-4992

NPI assigned

Dec 11, 2006

Last updated

Aug 18, 2022By 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

Itata Itata, ESQ.

Title

Ceo

Phone

(940) 566-4999

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033279252. Details of each certification follow.

• CCN 677962 Home health agency · Active · Details

Home health agency certification: CCN 677962

Legal name

PREMIER GOLDEN HEART HEALTH CARE SERVICES LLC

Doing business as

PREMIER GOLDEN HEART HEALTHCARE SERVICES

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 13, 2006

Last certification

Mar 22, 2021

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Dec 9, 2005 in TX

Enrollment address

2412 Old North Rd
Suite 101K
Denton, TX 76209-1415

Listed as

Premier Golden Heart Health Care Services, LLCCCN 677962 · All quality measures

Ownership

Proprietary

Certified

Jun 13, 2006

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 4

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

Owners & managing parties with NPI records 1

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

• Ndifreke Itata

  • Family Nurse Practitioner
  • Denton, TX
  • NPI 1174033286

  5% Or Greater Direct Ownership Interest, Corporate Director, W-2 Managing Employee

  CMS ownership

Practitioners 1

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.

• Ndifreke Itata

  • Family Nurse Practitioner
  • Denton, TX
  • NPI 1174033286
  NPD

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1033279252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 OLD NORTH RD STE 101K",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762091524",
            "telephone_number": "940-566-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 OLD NORTH RD STE 101K",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762091524",
            "telephone_number": "940-566-4999",
            "fax_number": "940-566-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER GOLDEN HEART HEALTH CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "ITATA",
        "authorized_official_first_name": "ITATA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "940-566-4999",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "010291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Denton, TX
• Providers in Denton, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.