Active NPI
Magna Home Health Care Inc.
- Home Health Agency
- Broken Arrow, OK
National Provider Identifier
1053303701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 7410
- Legal business name
- MAGNA HOME HEALTH CARE INC.
- Practice address
- 4271 W Albany St
Broken Arrow, OK 74012-1233 - Phone
- (918) 459-5073
- Fax
- (918) 459-5075
- NPI assigned
- Aug 18, 2005
- 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
- Ms. Christiana C Agbasi, RN
- Title
- Administrator
- Phone
- (918) 459-5073
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 7410 | OK | Primary |
Addresses
Primary practice location
4271 W Albany St
Broken Arrow, OK 74012-1233
Mailing address
4271 W Albany St
Broken Arrow, OK 74012-1233
Phone (918) 459-5073
Other names 1
- MAGNA HEALTH CARE SERVICES
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111201000786 | OK | Part A Provider - Home Health Agency | 0345415345 | Practice locations: Broken Arrow, OK |
Home health agency certification: CCN 377497
- Legal name
- MAGNA HOME HEALTH CARE INC.
- Doing business as
- MAGNA HEALTH CARE SERVICES
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Sep 5, 1995
- Last certification
- Mar 10, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Aug 5, 1995 in OK
- Enrollment address
- 4271 West Albany Street
Broken Arrow, OK 74012-1233
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Magna Home Health Care, Inc
- Ownership
- Proprietary
- Certified
- Sep 5, 1995
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy
National Provider Directory
National Provider DirectoryOwnership & 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 |
|---|---|---|---|
| Leonard Agbasi | 5% Or Greater Direct Ownership Interest | Apr 1, 1999 | 50% |
| Corporate Officer | Aug 9, 1995 | 25% | |
| Corporate Director | Aug 9, 1995 | 25% | |
| W-2 Managing Employee | Nov 15, 1995 | 25% | |
| Operational/Managerial Control | Aug 9, 1995 | 25% | |
| Christiana Agbasi | 5% Or Greater Direct Ownership Interest | Apr 1, 1999 | 50% |
| Corporate Officer | Aug 9, 1995 | 25% | |
| Corporate Director | Aug 9, 1995 | 25% | |
| W-2 Managing Employee | Sep 15, 1995 | 25% | |
| Operational/Managerial Control | Aug 9, 1995 | 25% |
Change-of-ownership history 1
| Date | Event | Counterparty |
|---|---|---|
| Nov 30, 2021 | Change of Ownership | A Path of Care Hospice II, LLC |
Change of ownership 1
Medicare changes of ownership in which this facility was the buyer or the seller.
-
- Community Based Hospice Care Agency
- Tulsa, OK
- NPI 1407512726
Sold to, 2021-11-30
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1301356800000",
"number": "1053303701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4271 W ALBANY ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740121233",
"telephone_number": "918-459-5073",
"fax_number": "918-459-5075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4271 W ALBANY ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740121233",
"telephone_number": "918-459-5073",
"fax_number": "918-459-5075"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAGNA HOME HEALTH CARE INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-18",
"last_updated": "2011-03-29",
"status": "A",
"authorized_official_last_name": "AGBASI",
"authorized_official_first_name": "CHRISTIANA",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "918-459-5073",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "OK",
"license": "7410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MAGNA HEALTH CARE SERVICES",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.