NPIMap

Organization Active NPI

Green Country Home Care, Inc.

  • Home Health Agency
  • McAlester, OK
National Provider Identifier
1053423681
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
7094 Issued in OK
Legal business name
GREEN COUNTRY HOME CARE, INC.
Practice address
405 E Chickasaw Ave
McAlester, OK 74501-5351
Phone
(918) 426-3700
Fax
(918) 426-5710
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alfred Ezell
Title
Owner
Phone
(918) 687-8033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 7094 OK Primary

Addresses

Primary practice location

405 E Chickasaw Ave
McAlester, OK 74501-5351

Mailing address

3310 Chandler Rd
Muskogee, OK 74403-4906
Phone (918) 687-8033

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080303000094 OK Part A Provider - Home Health Agency 6709960677 Practice locations: Atoka, OK; McAlester, OK; Poteau, OK; Seminole, OK

Home health agency certification: CCN 377206

Legal name
GREEN COUNTRY HOME CARE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 27, 1997
Last certification
May 8, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jul 1, 1993 in OK
Enrollment address
407 E Cherokee Ave
McAlester, OK 74501-5367
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Green Country Home Care, IncCCN 377206
Overall star rating
1.5 of 5
Ownership
Proprietary
Certified
Jan 27, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical 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
37D0857882Green Country Home Care, Inc405 East Chickasaw, McAlester, OK 74501Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1004 S Mississippi Ave
#A
Atoka, OK 74525
Phone (580) 889-1992

901 W Gentry Ave
Ste A
Checotah, OK 74426
Phone (918) 473-6483

405 E Chickasaw Ave
McAlester, OK 74501
Phone (918) 426-3700

500 S Broadway St
Ste B
Poteau, OK 74953
Phone (918) 208-7497

1421 W Wrangler Blvd
Seminole, OK 74868
Phone (405) 382-2773

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Alfred Ezell Individual 5% Or Greater Direct Ownership InterestAdministrator Apr 10, 1998 50%
5% Or Greater Indirect Ownership InterestAdministrator Apr 10, 1998 50%
Corporate OfficerPresident Apr 10, 1998 50%
Corporate Director Jan 18, 2008
Marianna Casebolt Individual Operational/Managerial ControlCfo Mar 15, 1999
Med Corp Health Services Inc Organization, Muskogee, OK Corporation 5% Or Greater Direct Ownership Interest Apr 10, 1998 100%
Kim Ezell Individual 5% Or Greater Direct Ownership Interest Jan 18, 2008
5% Or Greater Indirect Ownership Interest Apr 10, 1998 50%
Corporate OfficerSecretary Apr 10, 1998 50%
Corporate Director Jan 18, 2008

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1053423681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 CHANDLER RD",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744034906",
            "telephone_number": "918-687-8033",
            "fax_number": "918-687-4092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 E CHICKASAW AVE",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745015351",
            "telephone_number": "918-426-3700",
            "fax_number": "918-426-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN COUNTRY HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "EZELL",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-687-8033"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OK",
            "license": "7094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlester, OK

Sources for this page

Verify at the official NPI Registry.