Prolink Home Health Corporation

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

009767 Issued in TX

Legal business name

PROLINK HOME HEALTH CORPORATION

Practice address

4100 Medical Pkwy Ste 150
Carrollton, TX 75007-1541

Phone

(214) 267-1985

Fax

(214) 267-1983

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Joel Mathew

Title

Owner/Administartor

Phone

(214) 267-1985

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Home health agency certification: CCN 677805

Legal name

PROLINK HOME HEALTH CORPORATION

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 16, 2006

Last certification

Jul 7, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Mar 15, 2004 in TX

Enrollment address

4100 Medical Pkwy
Ste 150
Carrollton, TX 75007-1541

Listed as

Prolink Home Health CorporationCCN 677805

Ownership

Proprietary

Certified

Feb 16, 2006

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Locations

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.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1083711261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 MEDICAL PKWY STE 150",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750071541",
            "telephone_number": "214-267-1985",
            "fax_number": "214-267-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 MEDICAL PKWY STE 150",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750071541",
            "telephone_number": "214-267-1985",
            "fax_number": "214-267-1983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLINK HOME HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "OWNER/ADMINISTARTOR",
        "authorized_official_telephone_number": "214-267-1985",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "009767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS DEPARTMENT OF AGING AND DISABILITY SERVICES",
            "identifier": "LICENSE # 009767",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206172301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.

Verify at the official NPI Registry.