LHCG Xlii, LLC
Organization Active NPI Home Health Agency · Springdale, AR
NPI 1043557788 · NPPES record last updated Feb 13, 2024
Key facts
- NPI
- 1043557788
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- LHCG XLII, LLC
- Practice address
- 4847 Kaylee Ave Ste B
Springdale, AR 72762-0872 - Phone
- (479) 756-5002
- Fax
- (479) 756-5504
- NPI assigned
- Jan 15, 2013
- Organization subpart
- No
Authorized official
- Name
- Joshua L Proffitt
- Title
- President
- Phone
- (337) 233-1307
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 2
Facilities with the same owner 22
Practitioners 4
-
Trent Carter Moody, DPT
Affiliated clinicians 88
-
Michelle Chua Ang Poland, M.D.
-
James Baker, DO
-
Laura Beth Belviy, M.D.
-
Scott W Birch, MD
-
Kyle Blair, MD
-
Mark A Bonner, MD
-
Megan Elizabeth Busch, M.D.
-
John Elton Caswell, M.D.
-
David W Clay, MD
-
Mathew Jack Coker, M.D.
-
Randy Conover, D.O.
-
Emily J Coombs, APRN
-
Bruce D Deyoung, M.D.
-
Alan L. Diamond, DO
-
Paula Dillard, APRN
-
Kathryn Rae Dutton, DNP, AGACNP
-
Douglas Scott Eddy, M.D.
-
Hayden Elliott, MD
-
David Scott Estes, M.D.
-
Mary N Ford, MD
Medicare Care Compare: Home health agency
- Listed as
- Elite Home Health
- Overall star rating
- ★★★★☆ 4 of 5
- Ownership
- Proprietary
- Certified
- Jul 24, 1996
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D0929463 | Elite Home Health | Certificate of waiver | Jul 11, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Home health agency certification: CCN 047346
- Legal name
- LHCG XLII, LLC
- Doing business as
- ELITE HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jul 24, 1996
- Last certification
- Apr 6, 2018
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Jan 7, 2013 in AR
- Enrollment address
- 4847 Kaylee Ave
Ste B
Springdale, AR 72762-0872
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Arkansas Health Care Group LLC |
5% Or Greater Direct Ownership Interest | Mar 1, 2013 | 100% |
| Unitedhealth Group Incorporated |
5% Or Greater Indirect Ownership Interest | Feb 22, 2023 | 100% |
| Marcus Donavon Macip |
Corporate Officer |
Feb 22, 2023 | |
| Kimberly Seymour |
Corporate Officer |
Feb 22, 2023 | |
| Missy McAuley |
W-2 Managing Employee |
Aug 10, 2025 | |
| Wendy S Daigle |
Corporate Director |
Oct 1, 2022 | |
| LHC Group Inc |
5% Or Greater Indirect Ownership Interest | Mar 1, 2013 | 100% |
| Joshua Lee Proffitt |
Corporate Officer |
Mar 1, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130329000176 | AR | Part a Provider - Home Health Agency | 9436394129 | Practice locations: Springdale, AR |
National Provider Directory
- Tax ID family
- Elite Home Health
Locations
15506 Highway 5
Ste J
Cabot, AR 72023
Phone (501) 424-3100
2051 W Main St
Ste F
Cabot, AR 72023
Phone (501) 424-3100
2904 Jenny Lind Rd
Ste 9A
Fort Smith, AR 72901
Phone (479) 494-7273
650 S Shackleford Rd
Ste 303
Little Rock, AR 72211
Phone (501) 223-3333
2860 W Walnut St
Rogers, AR 72756
Phone (479) 621-8300
4847 Kaylee Ave
Ste B
Springdale, AR 72762
Phone (479) 756-5002
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes | ||
| Nursing Care Agency | 251J00000X | AR |
Addresses
Primary practice location
4847 Kaylee Ave Ste B
Springdale, AR 72762-0872
Mailing address
PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307
Other names
- Elite Home Health
Other providers in Springdale, AR
- Kathryn A. Levoir
- Kylee Lewis
- Madison Lewis
- Yolande Lewis
- LHCG Cii, LLC
- Emily Libertini
- Kirstie Liebenberg
- Kristen Leigh Lienhart
- Jennifer Elaine Light
- Sarah Ligon
All providers in Springdale, AR · Home Health Agency in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.