Active NPI
Tendercare LLC
- Home Health Agency
- Gillette, WY
National Provider Identifier
1033824909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- TENDERCARE LLC
- Practice address
- 400 S Gillette Ave Ste 109
Gillette, WY 82716-4252 - Phone
- (307) 670-2002
- NPI assigned
- Jan 16, 2023
- 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
- Melissa Cantu, REGISTERED NURSE
- Title
- Co-Owner
- Phone
- (307) 670-2002
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
400 S Gillette Ave Ste 109
Gillette, WY 82716-4252
Mailing address
400 S Gillette Ave Ste 109
Gillette, WY 82716-4252
Phone (307) 670-2002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240829004382 | WY | Part A Provider - Home Health Agency | 1951840206 | Practice locations: Gillette, WY |
Home health agency certification: CCN 537840
- Legal name
- TENDERCARE LLC
- Doing business as
- TENDERCARE HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Oct 22, 2025
- Last certification
- Oct 22, 2025
- Organization structure
- LLC
- Incorporated
- Jul 19, 2009 in WY
- Enrollment address
- 400 S Gillette Ave
Ste 109
Gillette, WY 82716-4252
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Tendercare Home Health
- Ownership
- -
- Certified
- Oct 22, 2025
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
400 S Gillette Ave
Ste 109
Gillette, WY 82716
Phone (307) 670-2002
Ownership & related parties
All disclosed owners & managing parties 2
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 |
|---|---|---|---|
| Ronda Boller | 5% Or Greater Direct Ownership Interest | Jul 19, 2009 | 50% |
| Melissa Cantu | 5% Or Greater Direct Ownership Interest | Oct 30, 2023 | 50% |
| W-2 Managing Employee | Oct 30, 2023 | 100% | |
| Operational/Managerial Control | Oct 30, 2023 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673827200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1692835200000",
"number": "1033824909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 S GILLETTE AVE STE 109",
"city": "GILLETTE",
"state": "WY",
"postal_code": "827164252",
"telephone_number": "307-670-2002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 S GILLETTE AVE STE 109",
"city": "GILLETTE",
"state": "WY",
"postal_code": "827164252",
"telephone_number": "307-670-2002"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TENDERCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-01-16",
"last_updated": "2023-08-24",
"certification_date": "2023-08-24",
"status": "A",
"authorized_official_last_name": "CANTU",
"authorized_official_first_name": "MELISSA",
"authorized_official_title_or_position": "CO-OWNER",
"authorized_official_telephone_number": "307-670-2002",
"authorized_official_credential": "REGISTERED NURSE"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gillette, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.