Active NPI
Vision 6 Corp
- Home Health Agency
- Montclair, CA
National Provider Identifier
1033301270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 550000537
- Legal business name
- VISION 6 CORP
- Practice address
- 5050 Palo Verde St
Suite 209
Montclair, CA 91763-2329 - Phone
- (909) 626-8221
- Fax
- (909) 626-1197
- NPI assigned
- Aug 12, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cez Michelle Felipe Tan
- Title
- Cfo/President/Administrator
- Phone
- (909) 626-8221
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 550000537 | CA | Primary |
Addresses
Primary practice location
5050 Palo Verde St
Suite 209
Montclair, CA 91763-2329
Mailing address
5050 Palo Verde St
Suite 209
Montclair, CA 91763-2329
Phone (909) 626-8221
Other names 1
- Inland Valley Home health Agency
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050801000703 | CA | Part A Provider - Home Health Agency | 1951339977 | Practice locations: Montclair, CA |
Home health agency certification: CCN 058436
- Legal name
- VISION 6 CORP
- Doing business as
- INLAND VALLEY HOME HEALTH AGENCY
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jan 31, 2008
- Last certification
- Sep 25, 2019
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Nov 12, 2004 in CA
- Enrollment address
- 5050 Palo Verde St
Ste 209
Montclair, CA 91763-2334
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Inland Valley Home Health Agency
- Overall star rating
- Ownership
- Proprietary
- Certified
- Jan 31, 2008
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D1048054 | Inland Valley Home Health Agency | Certificate of waiver | Nov 20, 2027 |
National Provider Directory
National Provider DirectoryLocations
5050 Palo Verde St
Ste 209
Montclair, CA 91763
Phone (909) 626-8221
Ownership & related parties
All disclosed owners & managing parties 1
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Justin I Felipe | 5% Or Greater Direct Ownership Interest | Apr 1, 2015 | 100% |
| Corporate Officer | Apr 1, 2015 | 100% | |
| Corporate Director | Apr 1, 2015 | 100% | |
| W-2 Managing Employee | Apr 1, 2015 | 100% | |
| Operational/Managerial Control | Apr 1, 2015 | 100% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186876800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1329264000000",
"number": "1033301270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5050 PALO VERDE ST",
"address_2": "SUITE 209",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "917632329",
"telephone_number": "909-626-8221",
"fax_number": "909-626-1197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5050 PALO VERDE ST",
"address_2": "SUITE 209",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "917632329",
"telephone_number": "909-626-8221",
"fax_number": "909-626-1197"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VISION 6 CORP",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-12",
"last_updated": "2012-02-15",
"status": "A",
"authorized_official_last_name": "TAN",
"authorized_official_first_name": "CEZ MICHELLE",
"authorized_official_middle_name": "FELIPE",
"authorized_official_title_or_position": "CFO/PRESIDENT/ADMINISTRATOR",
"authorized_official_telephone_number": "909-626-8221"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "CA",
"license": "550000537",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Inland Valley Home health Agency",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Montclair, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.