Organization Active NPI

Vision 6 Corp

  • Home Health Agency
  • Montclair, CA
National Provider Identifier
1033301270
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
550000537 Issued in CA
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

Updated by the provider on Feb 15, 2012

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationProprietary
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 AgencyCCN 058436
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Jan 31, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
05D1048054Inland Valley Home Health Agency5050 Palo Verde St Ste 209, Montclair, CA 91763Certificate of waiverNov 20, 2027

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Justin I Felipe Individual 5% Or Greater Direct Ownership Interest Apr 1, 2015 100%
Corporate OfficerCeo/President Apr 1, 2015 100%
Corporate DirectorCeo/President Apr 1, 2015 100%
W-2 Managing EmployeeCeo/President Apr 1, 2015 100%
Operational/Managerial ControlCeo/President 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

Verify at the official NPI Registry.