Med-Cert Home Care ,LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MED-CERT HOME CARE ,LLC

Practice address

1919 S Shiloh Rd Ste 660
Garland, TX 75042-8234

Phone

(972) 303-2424

Fax

(972) 303-1620

NPI assigned

Dec 2, 2009

Organization subpart

No

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

Authorized official

Name

Mathew John

Title

Cfo

Phone

(972) 303-2424

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Home health agency certification: CCN 747507

Legal name

MED-CERT HOME CARE ,LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 8, 2011

Last certification

Sep 5, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Nov 13, 2009 in TX

Enrollment address

1919 S Shiloh Rd
Ste 310
Garland, TX 75042-8293
HHA Branch

Listed as

Med-Cert Home Care LLCCCN 747507

Ownership

Proprietary

Certified

Feb 8, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

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

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1083942056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S SHILOH RD STE 660",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750428234",
            "telephone_number": "972-303-2424",
            "fax_number": "972-303-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S SHILOH RD STE 660",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750428234",
            "telephone_number": "972-303-2424",
            "fax_number": "972-303-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED-CERT HOME CARE ,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-02",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "972-303-2424"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.