Organization Active NPI

Dequincy Home Health Inc

  • Home Health Agency
  • Dequincy, LA
National Provider Identifier
1093708349
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1036 Issued in LA
Legal business name
DEQUINCY HOME HEALTH INC
Practice address
500 South Grand Avenue
Dequincy, LA 70633-3508
Phone
(337) 786-1638
Fax
(337) 786-2038
NPI assigned
Aug 23, 2005
Last updated
Jan 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Authorized official

Name
Mr. John A Matheson
Title
Owner/President
Phone
(337) 786-2900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1036 LA Primary

Addresses

Primary practice location

500 South Grand Avenue
Dequincy, LA 70633-3508

Mailing address

500 South Grand Avenue
PO Box 1095
Dequincy, LA 70633-3508
Phone (337) 786-1638

Other identifiers 2

IdentifierTypeStateIssuer
31245OtherLABCBS
1401960MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Apr 1, 2019 Change of OwnershipThis provider was the seller Allegiance Home Health of Southwest Louisiana, LLCCCN 197520, LA, NPI 1740844620

Change of ownership 1

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

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1093708349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SOUTH GRAND AVENUE",
            "address_2": "PO BOX 1095",
            "city": "DEQUINCY",
            "state": "LA",
            "postal_code": "706333508",
            "telephone_number": "337-786-1638",
            "fax_number": "337-786-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SOUTH GRAND AVENUE",
            "city": "DEQUINCY",
            "state": "LA",
            "postal_code": "706333508",
            "telephone_number": "337-786-1638",
            "fax_number": "337-786-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEQUINCY HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "MATHESON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "337-786-2900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "LA",
            "license": "1036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31245",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1401960",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dequincy, LA

Sources for this page

Verify at the official NPI Registry.