Active NPI
Ally Home Health LLC
- Home Health Agency
- Binger, OK
National Provider Identifier
1053743294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- HC8020
- Legal business name
- ALLY HOME HEALTH LLC
- Practice address
- 103 North Hermann Ave.
Binger, OK 73009-0000 - Phone
- (405) 656-2203
- Fax
- (855) 696-3030
- NPI assigned
- Jul 30, 2013
- Last updated
- Apr 19, 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
- Trenna Shotts
- Title
- Owner
- Phone
- (405) 574-4321
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | HC8020 | OK | Primary |
Addresses
Primary practice location
103 North Hermann Ave.
Binger, OK 73009-0000
Mailing address
PO Box R
Binger, OK 73009-0179
Phone (405) 656-2203
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200550780A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131010000658 | OK | Part A Provider - Home Health Agency | 7214161017 | Practice locations: Binger, OK |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1053743294. Details of each certification follow.
Home health agency certification: CCN 377773
- Legal name
- ALLY HOME HEALTH LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jan 23, 2014
- Last certification
- Oct 31, 2019
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Incorporated
- Jan 1, 2013 in OK
- Enrollment address
- 103 North Herman Street
Binger, OK 73009-0179
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Ally Home Health LLC
- Overall star rating
- Ownership
- Proprietary
- Certified
- Jan 23, 2014
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D2068576 | Ally Home Health LLC | Certificate of waiver | Nov 5, 2027 |
National Provider Directory
National Provider DirectoryLocations
212 W Main St
Binger, OK 73009
Phone (405) 656-2203
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Trenna L Shotts | 5% Or Greater Direct Ownership Interest | May 13, 2019 | 100% |
| Corporate Officer | Jan 1, 2013 | 100% | |
| W-2 Managing Employee | Jul 26, 2013 |
Practitioners & affiliated clinicians
Affiliated clinicians 16
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Nurse Practitioner
- Anadarko, OK
- NPI 1972939122
Home health agency
-
- Family Nurse Practitioner
- Okarche, OK
- NPI 1104278548
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375142400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1681862400000",
"number": "1053743294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX R",
"city": "BINGER",
"state": "OK",
"postal_code": "730090179",
"telephone_number": "405-656-2203",
"fax_number": "855-696-3030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 NORTH HERMANN AVE.",
"city": "BINGER",
"state": "OK",
"postal_code": "730090000",
"telephone_number": "405-656-2203",
"fax_number": "855-696-3030"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALLY HOME HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-07-30",
"last_updated": "2023-04-19",
"certification_date": "2023-04-19",
"status": "A",
"authorized_official_last_name": "SHOTTS",
"authorized_official_first_name": "TRENNA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "405-574-4321"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "OK",
"license": "HC8020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200550780A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Binger, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.