NPIMap

Organization Active NPI

LHCG Lxxxiv, LLC

  • Home Health Agency
  • Brewton, AL
National Provider Identifier
1083067904
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LHCG LXXXIV, LLC
Practice address
114 W Jackson St
Brewton, AL 36426-1516
Phone
(251) 867-5054
Fax
(251) 867-5135
NPI assigned
Jul 15, 2016
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Joshua L. Proffitt
Title
President
Phone
(337) 233-1307

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Facilities with the same owner 18

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 18

Affiliated clinicians 20

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 20

Care Compare: Home health agency

Medicare Care Compare
Listed as
D W McMillan Home HealthCCN 017143
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Jan 23, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161111000033 AL Part a Provider - Home Health Agency 6608155833 Practice locations: Brewton, AL

Home health agency certification: CCN 017143

Medicare enrollment files
Legal name
LHCG LXXXIV, LLC
Doing business as
D.W. MCMILLAN HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 23, 1995
Last certification
Jun 25, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jul 6, 2016 in AL
Enrollment address
114 W Jackson St
Brewton, AL 36426-1516

All disclosed owners & managing parties 10

Medicare enrollment files

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

NameRoleSinceShare
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 75%
Marcus Donavon Macip Individual Corporate OfficerSecretary Feb 22, 2023
Kimberly Seymour Individual Corporate OfficerCoo Apr 13, 2026
W-2 Managing EmployeeCoo Apr 13, 2026
Tiffany Eggert Individual W-2 Managing EmployeeAd; Aug 1, 2024
Joni Babineaux Individual Corporate OfficerCfo Apr 13, 2026
Escambia County Health Care Authority Organization, Brewton, AL Corporation 5% Or Greater Direct Ownership Interest Oct 1, 2016 25%
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Oct 1, 2016 75%
Operational/Managerial Control Oct 1, 2016
Joshua Lee Proffitt Individual Corporate OfficerPresident Oct 1, 2016
Alabama Health Care Group, LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Oct 1, 2016 75%
Amy Cormier Individual Corporate DirectorDirector, Managed Care Network May 1, 2025

Change-of-ownership history 1

Medicare enrollment files
DateEventCounterparty
Oct 1, 2016 Change of OwnershipThis provider was the buyer D.W. McMillan Home HealthCCN 017143, AL, NPI 1841306099

National Provider Directory

National Provider Directory
Tax ID family
Atmore Community Home Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

114 W Jackson St
Brewton, AL 36426-1516

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
205178MedicaidAL

Other names 1

NPPES NPI Registry
  • D.W. McMillan Home Health Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 23, 2024.

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1083067904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-233-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W JACKSON ST",
            "city": "BREWTON",
            "state": "AL",
            "postal_code": "364261516",
            "telephone_number": "251-867-5054",
            "fax_number": "251-867-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LHCG LXXXIV, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-15",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205178",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D.W. McMillan Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "D.W. McMillan Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brewton, AL

Sources for this page

Verify at the official NPI Registry.